NPIMap

Organization Active NPI

Odyssey Healthcare Operating a, LP

  • Home Health Agency
  • Harrison, AR
National Provider Identifier
1104580760
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ODYSSEY HEALTHCARE OPERATING A, LP
Practice address
105 E Crandall Ave
Harrison, AR 72601-3629
Phone
(870) 280-2926
Fax
(870) 204-6557
NPI assigned
Oct 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Janet L. Combs
Title
Authorized Official
Phone
(704) 664-2876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

105 E Crandall Ave
Harrison, AR 72601-3629

Mailing address

P.O. Box 4060
Attn: Regulatory
Mooresville, NC 28117
Phone (704) 664-2876

Other identifiers 1

IdentifierTypeStateIssuer
282954732MedicaidAR

Other names 1

  • Gentiva Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Odyssey Healthcare Operating a LP41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

Locations

105 E Crandall Ave
Harrison, AR 72601
Phone (870) 280-2926

NPI Registry JSON

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

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1104580760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4060",
            "address_2": "ATTN: REGULATORY",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-664-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E CRANDALL AVE",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726013629",
            "telephone_number": "870-280-2926",
            "fax_number": "870-204-6557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY HEALTHCARE OPERATING A, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282954732",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.