NPIMap

Organization Active NPI

Onesource Home Care, Inc.

  • Home Health Agency
  • Longview, TX
National Provider Identifier
1104147339
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ONESOURCE HOME CARE, INC.
Practice address
4002 Technology Ctr
Longview, TX 75605-2697
Phone
(903) 247-0484
Fax
(903) 247-0485
NPI assigned
Jun 22, 2010
Last updated
Aug 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Authorized official

Name
John D Ford
Title
President
Phone
(903) 247-0484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4002 Technology Ctr
Longview, TX 75605-2697

Mailing address

4002 Technology Ctr
Longview, TX 75605-2697
Phone (903) 247-0484

Other names 1

  • Grace Independent Home Care Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120822000330 TX Part A Provider - Home Health Agency 1355598616 Practice locations: Longview, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104147339. Details of each certification follow.

Home health agency certification: CCN 679138

Legal name
ONESOURCE HOME CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 30, 2002
Last certification
May 20, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 16, 2010 in TX
Enrollment address
4001 Technology Ctr
Ste 304
Longview, TX 75605-2757

Care Compare: Home health agency

Medicare Care Compare
Listed as
Onesource Home Care IncCCN 679138 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
May 30, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4001 Technology Ctr
Ste 304
Longview, TX 75605
Phone (903) 248-2530

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Primecare LLC Organization, Longview, TX LLC 5% Or Greater Direct Ownership Interest Jun 1, 2020 100%
Collom & Carney Clinic Association Organization, Texarkana, TX 5% Or Greater Indirect Ownership Interest Jun 1, 2020 33.33%
John Ford Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2020 33.33%
Corporate OfficerPresident Director Admin Jun 1, 2020
Corporate DirectorPresident Director Admin Jun 1, 2020
W-2 Managing EmployeePresident Director Admin Jun 1, 2020
Operational/Managerial ControlPresident Director Admin Jun 1, 2020
Associated Clinicians of East Texas Organization, Longview, TX LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2020 33.33%
Triad Physician Resources Organization, Longview, TX Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2020 33.33%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Prime Care Hospice LLC
    • Community Based Hospice Care Agency
    • Longview, TX
    • NPI 1467001628

    Associated Clinicians of East Texas, Collom & Carney Clinic Association, Triad Physician Resources

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1104147339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0484",
            "fax_number": "903-247-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 TECHNOLOGY CTR",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756052697",
            "telephone_number": "903-247-0484",
            "fax_number": "903-247-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONESOURCE HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-247-0484"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Independent Home Care Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.