NPIMap

Organization Active NPI

Omni Home Health Hernando, LLC

Doing business as SunCrest OMNI

  • Home Health Agency
  • Lake City, FL
National Provider Identifier
1124012976
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299991577 Issued in FL
Legal business name
OMNI HOME HEALTH HERNANDO, LLC
Doing business as
SunCrest OMNI
Practice address
426 SW Commerce Dr Ste 110
Lake City, FL 32025-1506
Phone
(386) 754-6671
Fax
(386) 754-8673
NPI assigned
Sep 8, 2005
Last updated
Jun 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Authorized official

Name
Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299991577 FL Primary

Addresses

Primary practice location

426 SW Commerce Dr Ste 110
Lake City, FL 32025-1506

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other identifiers 1

IdentifierTypeStateIssuer
004157000MedicaidFL

Other names 1

  • SunCrest OMNI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050524000420 FL Part A Provider - Home Health Agency 7810939568 5 other NPIs on this enrollment
Practice locations: Lake City, FL; Newberry, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124012976. Details of each certification follow.

Home health agency certification: CCN 107690

Legal name
OMNI HOME HEALTH- HERNANDO, LLC
Doing business as
SUNCREST OMNI
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 14, 2002
Last certification
Dec 7, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 6, 2001 in FL
Enrollment address
426 SW Commerce Dr
Ste 110
Lake City, FL 32025-1506
HHA Branch

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Suncrest OmniCCN 107690 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Feb 14, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0992810Suncrest Omni426 SW Commerce Drive, Ste 110, Lake City, FL 32025Certificate of waiverOct 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Omni Home Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

914 N Suncoast Blvd
Crystal River, FL 34429
Phone (352) 628-4900

2114 NW 40th Ter
Ste D2
Gainesville, FL 32605
Phone (352) 448-1134

4359 S Suncoast Blvd
Homosassa, FL 34446
Phone (352) 628-4900

426 SW Commerce Dr
Ste 110
Lake City, FL 32025
Phone (386) 754-6671

2229 Citrus Blvd
Leesburg, FL 34748
Phone (325) 315-1150

95 NW 253rd St
Newberry, FL 32669
Phone (352) 384-9240

3900 Crill Ave
Palatka, FL 32177
Phone (386) 312-0646

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Omni Home Health Services LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Dec 7, 2013 100%
Omni Home Health Holdings Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Nicholas Gachassin Individual Corporate OfficerSecretary / Treasurer Dec 1, 2019
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Apr 30, 2018
Almost Family, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
National Health Industries, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Michelle Douglas Individual W-2 Managing EmployeeAdministrator Oct 8, 2022

Facilities with the same owner 111

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

View all 111

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687392000000",
    "number": "1124012976",
    "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": "426 SW COMMERCE DR STE 110",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251506",
            "telephone_number": "386-754-6671",
            "fax_number": "386-754-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HOME HEALTH HERNANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-08",
        "last_updated": "2023-06-22",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299991577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004157000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest OMNI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SunCrest OMNI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.