Active NPI
Senior Preferred Homecare LLC
- Home Health Agency
- Austin, TX
National Provider Identifier
1114248705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 013558
- Legal business name
- SENIOR PREFERRED HOMECARE LLC
- Practice address
- 223 W Anderson LN Ste A115
Austin, TX 78752-1212 - Phone
- (512) 800-8911
- Fax
- (512) 777-5044
- NPI assigned
- Jun 17, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan W Kim
- Title
- Cfo
- Phone
- (512) 284-7757
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 013558 | TX | Primary |
Addresses
Primary practice location
223 W Anderson LN Ste A115
Austin, TX 78752-1212
Mailing address
223 W Anderson LN Ste A115
Austin, TX 78752-1212
Phone (512) 800-8911
Other names 1
- Farmers Homecare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110510000333 | TX | Part A Provider - Home Health Agency | 4082890066 | Practice locations: Austin, TX |
Home health agency certification: CCN 747636
- Legal name
- SENIOR PREFERRED HOMECARE LLC
- Doing business as
- FARMERS HOMECARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 8, 2011
- Last certification
- Apr 1, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Jun 7, 2010 in TX
- Enrollment address
- 223 W Anderson LN
Ste A115
Austin, TX 78752-1212
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Farmers Homecare
- Ownership
- Proprietary
- Certified
- Dec 8, 2011
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2011144 | Senior Preferred Homecare LLC | Certificate of waiver | Aug 11, 2026 |
National Provider Directory
National Provider DirectoryLocations
223 W Anderson Ln
Ste A115
Austin, TX 78752
Phone (512) 800-8588
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Ryan W Kim | 5% Or Greater Direct Ownership Interest | Nov 8, 2019 | 100% |
| Corporate Director | Nov 8, 2019 | ||
| W-2 Managing Employee | Nov 8, 2019 | ||
| Son Terry | Corporate Officer | Sep 1, 2023 | |
| W-2 Managing Employee | Sep 1, 2023 |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276732800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1718064000000",
"number": "1114248705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 W ANDERSON LN STE A115",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787521212",
"telephone_number": "512-800-8911",
"fax_number": "512-777-5044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 W ANDERSON LN STE A115",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787521212",
"telephone_number": "512-800-8911",
"fax_number": "512-777-5044"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SENIOR PREFERRED HOMECARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-06-17",
"last_updated": "2024-06-11",
"certification_date": "2024-06-11",
"status": "A",
"authorized_official_last_name": "KIM",
"authorized_official_first_name": "RYAN",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "512-284-7757"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "013558",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Farmers Homecare",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.