NPIMap

Organization Active NPI

Bay Area Home Health Operations LLC

Doing business as Oregon Coast Home Health

  • Home Health Agency
  • Coos Bay, OR
National Provider Identifier
1134801806
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BAY AREA HOME HEALTH OPERATIONS LLC
Doing business as
Oregon Coast Home Health
Practice address
650 Anderson Ave Ste 650
Coos Bay, OR 97420-1672
Phone
(541) 269-5454
Fax
(541) 269-2828
NPI assigned
Aug 2, 2023
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Mr. Matthew Ham
Title
Authorized Official
Phone
(541) 269-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

650 Anderson Ave Ste 650
Coos Bay, OR 97420-1672

Mailing address

650 Anderson Ave Ste 650
Coos Bay, OR 97420-1672
Phone (541) 269-5454

Other names 1

  • Oregon Coast Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231113003214 OR Part A Provider - Home Health Agency 9830546829 Practice locations: Coos Bay, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134801806. Details of each certification follow.

Home health agency certification: CCN 387039

Legal name
BAY AREA HOME HEALTH OPERATIONS LLC
Doing business as
OREGON COAST HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 1, 1978
Last certification
Nov 9, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 1, 2023 in OR
Enrollment address
650 Anderson Ave
Ste 650
Coos Bay, OR 97420-1672

Care Compare: Home health agency

Medicare Care Compare
Listed as
Oregon Coast Home HealthCCN 387039 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jan 1, 1978
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
38D0898358Bay Area Home Health Operations LLC Dba650 Anderson Avenue, Suite 650, Coos Bay, OR 97420Certificate of waiverDec 31, 2027

National Provider Directory

National Provider Directory

Locations

650 Anderson Ave
Ste 650
Coos Bay, OR 97420
Phone (541) 269-5454

3950 Sherman Ave
North Bend, OR 97459
Phone (541) 217-5239

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Katlin Marie Henris Individual W-2 Managing EmployeeAd; Sep 28, 2023
Bay Area Home Health Holdings LLC Organization, Coos Bay, OR Created for acquisition, LLC, Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 1, 2023 100%
Matthew David Ham Individual 5% Or Greater Indirect Ownership InterestCeo Aug 1, 2023 33.3%
Corporate OfficerCeo Aug 1, 2023
Operational/Managerial ControlCeo Aug 1, 2023
Travis Beardall Individual 5% Or Greater Indirect Ownership Interest Aug 1, 2023 33.3%
Highland Health Services LLC Organization, Coos Bay, OR LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 1, 2023 100%
Wade Pellatt Individual 5% Or Greater Indirect Ownership InterestCoo Aug 1, 2023 33.3%
Corporate OfficerCoo Aug 1, 2023
Operational/Managerial ControlCoo Aug 1, 2023

Change-of-ownership history 1

DateEventCounterparty
Aug 17, 2023 Change of OwnershipThis provider was the buyer Bay Area HospitalCCN 387039, OR, NPI 1215018197

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1134801806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 ANDERSON AVE STE 650",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201672",
            "telephone_number": "541-269-5454",
            "fax_number": "541-269-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ANDERSON AVE STE 650",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201672",
            "telephone_number": "541-269-5454",
            "fax_number": "541-269-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA HOME HEALTH OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "HAM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "541-269-5454",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oregon Coast Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oregon Coast Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coos Bay, OR

Sources for this page

Verify at the official NPI Registry.