Elk Valley Home Health Care Agency, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

0161 Issued in TN

Legal business name

ELK VALLEY HOME HEALTH CARE AGENCY, LLC

Practice address

1820 Huntsville Hwy
Suite a
Fayetteville, TN 37334-3789

Phone

(931) 433-7026

Fax

(931) 433-0341

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Donald D. Stelly

Title

President

Phone

(337) 233-1307

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Deaconess HomeCare Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Tennessee in-Home Partner-III, LLC

  • Home Health Agency
  • Fayetteville, TN
  • NPI 1639677610

  Sold to, 2018-03-01

  CMS change of ownership

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396569600000",
    "number": "1104817634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 HUNTSVILLE HWY",
            "address_2": "SUITE A",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373343789",
            "telephone_number": "931-433-7026",
            "fax_number": "931-433-0341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK VALLEY HOME HEALTH CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2014-04-04",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "0161",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0447109",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kay D. Eason, MED/CCC-SLP
• William A Edwards, M.D.
• Efc #2
• Elk River Chiropractic LLC
• Elk River Health & Nursing Center of Fayetteville LLC
• Elk Valley Medical Clinic, LLC
• Encore Rehabilitation, Inc.
• Encore Rehabilitation, Inc.
• Crystal Baker English, MSN, APRN, FNP-C
• Cynthia A. English, R.N.

• Home Health Agency in Fayetteville, TN
• Providers in Fayetteville, TN by specialty
• Home Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.