Organization Active NPI

Bethel America Health Care LLC

  • Home Health Agency
  • Stafford, TX
National Provider Identifier
1093945701
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
68783
Legal business name
BETHEL AMERICA HEALTH CARE LLC
Practice address
11104 W Airport Blvd Ste 107
Stafford, TX 77477-3016
Phone
(832) 770-9125
Fax
(832) 770-9253
NPI assigned
Jul 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Yamilet FernandezNPI 1003947672
Title
Administrator
Phone
(832) 770-9125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 68783 Primary

Addresses

Primary practice location

11104 W Airport Blvd Ste 107
Stafford, TX 77477-3016

Mailing address

11104 W Airport Blvd Ste 107
Stafford, TX 77477-3016
Phone (832) 770-9125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100714000400 TX Part A Provider - Home Health Agency 9830221639 Practice locations: Stafford, TX

Home health agency certification: CCN 747530

Legal name
BETHEL AMERICA HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 4, 2011
Last certification
Jan 23, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 20, 2009 in TX
Enrollment address
11104 W. Airport Blvd.
Suite 107
Stafford, TX 77477

Care Compare: Home health agency

Medicare Care Compare
Listed as
Bethel America Health Care LLCCCN 747530
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 4, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2000412Bethel America Health Care LLC11104 West Airport Blvd Suite 107, Stafford, TX 77477Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory

Locations

11104 W Airport Blvd
Ste 107
Stafford, TX 77477
Phone (832) 770-9125

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Yamilet Fernandez Individual 5% Or Greater Direct Ownership Interest Oct 23, 2017 100%
Corporate OfficerPresident, Asst. Administrator Oct 23, 2017 100%
W-2 Managing EmployeeAd; Oct 23, 2017 100%
Rosalind Pratt Individual Contracted Managing EmployeeAlt Administrator Apr 28, 2017
Nemia Jamora Individual W-2 Managing EmployeeDirector of Nurses(Don) Jan 10, 2025
Laura Diaz Matos Individual Contracted Managing EmployeeAlt. Director of Nurses (Adon) Aug 1, 2024

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1093945701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11104 W AIRPORT BLVD STE 107",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773016",
            "telephone_number": "832-770-9125",
            "fax_number": "832-770-9253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11104 W AIRPORT BLVD STE 107",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773016",
            "telephone_number": "832-770-9125",
            "fax_number": "832-770-9253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL AMERICA HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-16",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "YAMILET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-770-9125",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": "68783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

Verify at the official NPI Registry.