NPIMap

Organization Active NPI

Pinnacle Care Holdings LLC

  • Home Health Agency
  • Zachary, LA
National Provider Identifier
1124556287
Registry record updated Jun 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PINNACLE CARE HOLDINGS LLC
Practice address
5333 Main St
Zachary, LA 70791-3956
Phone
(225) 248-8600
NPI assigned
Jun 1, 2017
Organization subpart
Yes
Parent organization
PINNACLE CARE HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2017

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

Authorized official

Name
Kelly Tullier
Title
Cfo
Phone
(225) 248-8600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

5333 Main St
Zachary, LA 70791-3956

Mailing address

5627 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6032
Phone (225) 248-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170825001762 LA Part A Provider - Home Health Agency 7315219383 Practice locations: Zachary, LA

Home health agency certification: CCN 197607

Legal name
PINNACLE CARE HOLDINGS LLC
Doing business as
PINNACLE HOME HEALTH OF ZACHARY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 15, 1993
Last certification
Jan 9, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
May 26, 2017 in LA
Enrollment address
5333 Main Street
Zachary, LA 70791-3956

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Pinnacle Home Health of ZacharyCCN 197607
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Oct 15, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Care Holdings LLC5 organizations share this tax ID, including this one
Part of
Pinnacle Care Holdings LLC

Other organizations with this tax ID 4

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Our Lady of the Lake Hospital Inc Organization, Baton Rouge, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 18, 2017 100%
Franciscan Missionaries of Our Lady Health System Inc Organization, Baton Rouge, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 18, 2017 100%
Jonathan P Lyons Individual 5% Or Greater Direct Ownership Interest Jun 18, 2017 10%
W-2 Managing EmployeeCeo Jun 18, 2017
Kelly T Tullier Individual 5% Or Greater Direct Ownership Interest Jun 18, 2017 10%
Fmol-North American Providence Inc Organization, Baton Rouge, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 18, 2017 100%

Owners & managing parties with NPI records 6

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

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

View all 19

Change-of-ownership history 1

DateEventCounterparty
Jun 18, 2017 Change of OwnershipThis provider was the buyer Pinnacle Home Health Care 2005 LLCCCN 197607, LA, NPI 1851376081

Change of ownership 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1496275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496275200000",
    "number": "1124556287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166032",
            "telephone_number": "225-248-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5333 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913956",
            "telephone_number": "225-248-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE CARE HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE CARE HOLDINGS LLC",
        "enumeration_date": "2017-06-01",
        "last_updated": "2017-06-01",
        "status": "A",
        "authorized_official_last_name": "TULLIER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-248-8600"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.