Organization Active NPI

Horizon Home Care

  • Home Health Agency
  • Tewksbury, MA
National Provider Identifier
1184043671
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
HORIZON HOME CARE
Practice address
2314 Main St
Tewksbury, MA 01876-3128
Phone
(978) 851-7775
Fax
(978) 851-7779
NPI assigned
Apr 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Derek Proctor
Title
Administrator/Owner
Phone
(978) 851-7775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2314 Main St
Tewksbury, MA 01876-3128

Mailing address

2314 Main St
Tewksbury, MA 01876-3128
Phone (978) 851-7775

Other identifiers 1

IdentifierTypeStateIssuer
110103288AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140708002022 MA Part A Provider - Home Health Agency 7214152149 Practice locations: Tewksbury, MA

Home health agency certification: CCN 227600

Legal name
HORIZON HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 13, 2015
Last certification
Feb 13, 2015
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 10, 2014 in MA
Enrollment address
2314 Main St
Tewksbury, MA 01876-3128
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Horizon Home Care, LLCCCN 227600
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
Feb 13, 2015
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, 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
22D2078331Horizon Home Care, LLC2314 Main St, Tewksbury, MA 01876Certificate of waiverMay 26, 2028

National Provider Directory

National Provider Directory

Locations

2314 Main St
Tewksbury, MA 01876
Phone (978) 851-7775

853 Main St
Ste 214
Tewksbury, MA 01876
Phone (978) 851-7775

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Linda a Proctor Individual 5% Or Greater Direct Ownership Interest Aug 1, 2015 33%
Corporate OfficerCfo Aug 1, 2015 33%
W-2 Managing EmployeeCfo Aug 1, 2015 33%
Robert E Proctor Individual 5% Or Greater Direct Ownership Interest Aug 1, 2015 34%
Corporate OfficerCoo Aug 1, 2015 34%
W-2 Managing EmployeeCoo Aug 1, 2015 34%
Derek R Proctor Individual 5% Or Greater Direct Ownership Interest Aug 1, 2015 33%
Corporate OfficerCeo Aug 1, 2015 33%
W-2 Managing EmployeeCeo Aug 1, 2015 33%

NPI Registry JSON

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

{
    "created_epoch": "1397088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1184043671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2314 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763128",
            "telephone_number": "978-851-7775",
            "fax_number": "978-851-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763128",
            "telephone_number": "978-851-7775",
            "fax_number": "978-851-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON HOME CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-10",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "978-851-7775"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110103288A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.