Active NPI
Impact Homehealth Care Agency LLC
- Home Health Agency
- Aurora, CO
National Provider Identifier
1124738737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- IMPACT HOMEHEALTH CARE AGENCY LLC
- Practice address
- 17524 E Dickenson PL
Aurora, CO 80013-4178 - Phone
- (720) 495-6737
- NPI assigned
- Dec 5, 2022
- 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
- Tigist Woldegiorgis
- Title
- Owner/Vice President
- Phone
- (720) 695-9993
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
17524 E Dickenson PL
Aurora, CO 80013-4178
Mailing address
17524 E Dickenson PL
Aurora, CO 80013-4178
Phone (720) 695-9993
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240815002499 | CO | Part A Provider - Home Health Agency | 5395283832 | Practice locations: Aurora, CO |
Home health agency certification: CCN 067659
- Legal name
- IMPACT HOMEHEALTH CARE AGENCY LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 23, 2025
- Last certification
- Dec 18, 2025
- Organization structure
- LLC
- Enrollment address
- 17524 E Dickenson PL
Aurora, CO 80013-4178
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 4
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 |
|---|---|---|---|
| Mebratu Shibabaw | 5% Or Greater Direct Ownership Interest | Dec 5, 2022 | 50% |
| Corporate Officer | Dec 5, 2022 | 50% | |
| Corporate Director | Dec 5, 2022 | 50% | |
| W-2 Managing Employee | Dec 5, 2022 | 25% | |
| Melese Altaye | W-2 Managing Employee | Dec 5, 2022 | 25% |
| Tigist Woldegiorgis | 5% Or Greater Direct Ownership Interest | Dec 5, 2022 | 50% |
| Corporate Officer | Dec 5, 2022 | 50% | |
| Corporate Director | Dec 5, 2022 | 50% | |
| W-2 Managing Employee | Dec 5, 2022 | 25% | |
| Sisay Golla | W-2 Managing Employee | Dec 5, 2022 | 25% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670198400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1781827200000",
"number": "1124738737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17524 E DICKENSON PL",
"city": "AURORA",
"state": "CO",
"postal_code": "800134178",
"telephone_number": "720-695-9993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17524 E DICKENSON PL",
"city": "AURORA",
"state": "CO",
"postal_code": "800134178",
"telephone_number": "720-495-6737"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IMPACT HOMEHEALTH CARE AGENCY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-12-05",
"last_updated": "2026-06-19",
"certification_date": "2026-06-19",
"status": "A",
"authorized_official_last_name": "WOLDEGIORGIS",
"authorized_official_first_name": "TIGIST",
"authorized_official_title_or_position": "OWNER/VICE PRESIDENT",
"authorized_official_telephone_number": "720-695-9993"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
- Sarah Beth Imbler, MA, LPC
- Lauren Marie Imbornoni, M.D.
- Amanda Imbrosciano
- Denise Lea Imbusch, PTA
- Immaculate Care Optimal Nursing Home & Health LLC
- Impact Homehealth Care Agency LLC
- Emily Dee Imsirovic, PHARM.D.
- Nina Imsirpasic, RDH
- Inadvance Medicine Associates PA
- Keisha Indenbaum-Bates, DNP, FNP-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.