Active NPI
Horizon Home Care
- Home Health Agency
- Tewksbury, MA
National Provider Identifier
1184043671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110103288A | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- Incorporated
- Apr 10, 2014 in MA
- Enrollment address
- 2314 Main St
Tewksbury, MA 01876-3128
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Horizon Home Care, LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Feb 13, 2015
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 22D2078331 | Horizon Home Care, LLC | Certificate of waiver | May 26, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Linda a Proctor | 5% Or Greater Direct Ownership Interest | Aug 1, 2015 | 33% |
| Corporate Officer | Aug 1, 2015 | 33% | |
| W-2 Managing Employee | Aug 1, 2015 | 33% | |
| Robert E Proctor | 5% Or Greater Direct Ownership Interest | Aug 1, 2015 | 34% |
| Corporate Officer | Aug 1, 2015 | 34% | |
| W-2 Managing Employee | Aug 1, 2015 | 34% | |
| Derek R Proctor | 5% Or Greater Direct Ownership Interest | Aug 1, 2015 | 33% |
| Corporate Officer | Aug 1, 2015 | 33% | |
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.