A Path of Care Home Health IV, LLC
Organization Active NPI Home Health Agency · Coalgate, OK
NPI 1104257534 · NPPES record last updated May 5, 2026
Key facts
- NPI
- 1104257534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 7041 (OK)
- Legal business name
- A PATH OF CARE HOME HEALTH IV, LLC
- Practice address
- 1 N Arno St
Coalgate, OK 74538-2401 - Phone
- (580) 927-2600
- Fax
- (580) 927-2815
- NPI assigned
- Dec 11, 2013
- Organization subpart
- No
Authorized official
- Name
- Mr. John Kelly
- Title
- Manager of LLC
- Phone
- (405) 928-2727
Member of 1
Facilities with the same owner 9
Affiliated clinicians 19
-
Carol Lynn Black, APRN-CNP
-
Jessica Nicole Branton, APRN, CNP
-
Kathy Bryant, APRN NP-C
-
Rachel Lauren Burgess, APRN, FNP-C
-
Ruth Elaine Fereday, PA-C
-
Gabriela Frazier, FNP
-
Michael J Irvin, D.O
-
Jeffrey Moore, MD
-
Jodie H Moore, APRN-CNP
-
Charity Faith Rosenthal, NP-BC
-
Rebecca Smith, APRN
-
Tommie Gay Stanberry, PA-C
-
Meghan Fomby, RN, FNP
Medicare Care Compare: Home health agency
- Listed as
- A Path of Care Tendercare Home Health
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Sep 2, 1992
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 37D2077878 | A Path of Care Tendercare Home Health | Certificate of waiver | May 15, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Home health agency certification: CCN 377202
- Legal name
- A PATH OF CARE HOME HEALTH IV LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 2, 1992
- Last certification
- Jan 9, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 5, 2013 in OK
- Enrollment address
- 1 N Arno St
Ste a
Coalgate, OK 74538-2401
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Home Health Holdings LLP |
5% Or Greater Indirect Ownership Interest | Jan 17, 2014 | 100% |
| Innovative Capital Management LLC |
Operational/Managerial Control | Jan 17, 2014 | 100% |
| John Kelly |
Corporate Officer |
Jan 17, 2014 | 100% |
| Operational/Managerial Control |
Jan 17, 2014 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140410000431 | OK | Part a Provider - Home Health Agency | 9739311564 | Practice locations: Hugo, OK; Kingston, OK; Coalgate, OK |
National Provider Directory
Locations
1 N Arno St
Ste A
Coalgate, OK 74538
Phone (580) 927-2600
1 N Arno St
Coalgate, OK 74538
Phone (580) 927-2327
1309 E Jackson St
Hugo, OK 74743
Phone (580) 297-7910
601 Highway 70 N
Kingston, OK 73439
Phone (580) 369-5592
2910 Adams Rd
Norman, OK 73069
Phone (877) 247-7868
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 7041 | OK | Yes |
Addresses
Primary practice location
1 N Arno St
Coalgate, OK 74538-2401
Mailing address
2910 Adams Rd
Norman, OK 73069-1023
Phone (405) 928-2727
Other practice location 1
1309 E Jackson St
Hugo, OK 74743-4231
Phone (580) 297-7910
Other practice location 2
601 Highway 70 N
Kingston, OK 73439-8206
Phone (580) 564-0000
Other names
- TenderCare Home Health
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Other providers in Coalgate, OK
All providers in Coalgate, OK · Home Health Agency in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.