NPIMap

Organization Active NPI

Kingman Healthcare, Inc

Doing business as Kingman Regional Medical Center Home Health

  • Home Health Agency
  • Kingman, AZ
National Provider Identifier
1174701478
Registry record updated Apr 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA0059 Issued in AZ
Legal business name
KINGMAN HEALTHCARE, INC
Doing business as
Kingman Regional Medical Center Home Health
Practice address
2202 N Stockton Hill Rd Ste 200
Kingman, AZ 86401-4622
Phone
(928) 757-0630
NPI assigned
Feb 8, 2008
Last updated
Apr 24, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
KINGMAN HEALTHCARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 24, 2026

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

Authorized official

Name
Joshua Hoffman
Title
Cfo
Phone
(928) 263-3087

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA0059 AZ Primary

Addresses

Primary practice location

2202 N Stockton Hill Rd Ste 200
Kingman, AZ 86401-4622

Mailing address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619
Phone (928) 263-4722

Other identifiers 2

IdentifierTypeStateIssuer
738156MedicaidAZ
P0074390OtherAZBCBS

Other names 2

  • Kingman Regional Medical Center Home Health Doing business as
  • Kingman Hospital, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101021000228 AZ Part A Provider - Home Health Agency 6901791367 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kingman, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174701478. Details of each certification follow.

Home health agency certification: CCN 037050

Legal name
KINGMAN HEALTHCARE INC
Doing business as
KINGMAN REGIONAL MEDICAL CENTER HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 17, 1984
Last certification
Feb 27, 2020
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 1983 in AZ
Enrollment address
2202 N Stockton Hill Rd
Ste 200
Kingman, AZ 86401-4622

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kingman Regional Medical Center Home HealthCCN 037050 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Apr 17, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Kingman Healthcare Inc5 organizations share this tax ID, including this one
Part of
Kingman Healthcare Inc

Other organizations with this tax ID 4

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

Locations

2202 N Stockton Hill Rd
Ste 200
Kingman, AZ 86401
Phone (928) 692-4680

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/kingman-95fae3c0

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Joseph Dorner Individual Corporate DirectorBoard Member Aug 28, 2018
Ryan E Swapp Individual Corporate DirectorBoard Member Aug 24, 2021
Heath a Evans Individual Corporate OfficerCeo Feb 20, 2023
W-2 Managing EmployeeCeo Feb 20, 2023
Cathy Ott Individual Corporate DirectorBoard Member Jan 27, 2005
Lynne Petersen Individual Corporate DirectorBoard Member Aug 23, 2017
Krystal Burge Individual Corporate DirectorBoard Member Oct 28, 2004
Susan Chan Individual Corporate DirectorBoard Member Nov 1, 2007
Joshua R Hoffman Individual Corporate OfficerCfo Feb 11, 2023
W-2 Managing EmployeeCfo Feb 11, 2023
Coral Loyd Individual Corporate DirectorBoard Member Aug 25, 2015
Robert Devries Individual Corporate DirectorBoard Member Aug 24, 2021
Kale Bodily Individual Corporate DirectorBoard Member Oct 25, 2012
Sharmila Parvathaneni Individual Corporate DirectorChief of Staff Jul 1, 2022
James Baker Individual Corporate DirectorBoard Member Oct 23, 2008
Dan Delmonaco Individual Corporate DirectorBoard Member Feb 26, 2019

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776988800000",
    "number": "1174701478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 N STOCKTON HILL RD",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093619",
            "telephone_number": "928-263-4722",
            "fax_number": "928-263-4794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N STOCKTON HILL RD STE 200",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014622",
            "telephone_number": "928-757-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGMAN HEALTHCARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KINGMAN HEALTHCARE, INC",
        "enumeration_date": "2008-02-08",
        "last_updated": "2026-04-24",
        "certification_date": "2026-04-24",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "928-263-3087"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA0059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "738156",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "P0074390",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingman Regional Medical Center Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kingman Hospital, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.