Phenyx Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PHENYX HOME CARE LLC

Practice address

6425 NW Cache Rd Ste 102
Lawton, OK 73505-3391

Phone

(580) 699-3094

Fax

(580) 699-3093

NPI assigned

Feb 12, 2024

Last updated

Feb 12, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robin Kruthers, RN

Title

Owner/Co-Ceo

Phone

(580) 647-0792

Specialties & licenses 1

Addresses

Other names 1

• Phenyx Home Care Other name

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184488868. Details of each certification follow.

• CCN 377874 Home health agency · Active · Details

Home health agency certification: CCN 377874

Legal name

PHENYX HOME CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 30, 2024

Last certification

Jul 18, 2024

Organization structure

LLCProprietary

Incorporated

Jul 17, 2023 in OK

Enrollment address

6425 NW Cache Rd
Ste 102
Lawton, OK 73505-3391

Listed as

Phenyx Home Care LLCCCN 377874 · All quality measures

Overall star rating

2 of 5

Ownership

-

Certified

Jul 30, 2024

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

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

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1184488868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6425 NW CACHE RD STE 102",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053391",
            "telephone_number": "580-699-3094",
            "fax_number": "580-699-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 NW CACHE RD STE 102",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735053391",
            "telephone_number": "580-699-3094",
            "fax_number": "580-699-3093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHENYX HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "KRUTHERS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER/CO-CEO",
        "authorized_official_telephone_number": "580-647-0792",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phenyx Home Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Perpetua Petersen, CARE COORDINATOR
• Neli Petkova
• Anke Peyton, LPC CANDIDATE
• PF Lawton SNF Ops, LLC (Montevista Rehabilitation and Skilled Care)
• Shelley Ozio Phelps, LPC
• Phillips Chiropractic ,PLLC
• April Phillips
• Frederick B Phillips Jr., D.C.
• Jenny Phillips
• Kevin Phillips, DPH

• Home Health Agency in Lawton, OK
• Providers in Lawton, OK by specialty
• Home Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.

Verify at the official NPI Registry.