Organization Active NPI

Summit Home Health Care

  • Home Health Agency
  • Laramie, WY
National Provider Identifier
1184777625
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
07 096 Issued in WY
Legal business name
SUMMIT HOME HEALTH CARE
Practice address
204 McCollum Dr
Suite 106
Laramie, WY 82070-5103
Phone
(307) 721-2827
Fax
(307) 742-3611
NPI assigned
Jan 19, 2007
Last updated
Nov 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Authorized official

Name
Mrs. Katherine Anne Klein, RN
Title
President
Phone
(307) 721-2827

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 10236 WY
Home Health Agency 251E00000X 07 096 WY Primary

Addresses

Primary practice location

204 McCollum Dr
Suite 106
Laramie, WY 82070-5103

Mailing address

204 McCollum Dr
Suite 106
Laramie, WY 82070-5103
Phone (307) 721-2827

Other identifiers 3

IdentifierTypeStateIssuer
119002402MedicaidWY
119002401MedicaidWY
119002400MedicaidWY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

1401 Airport Pkwy
Ste 220
Cheyenne, WY 82001
Phone (307) 778-3000

204 McCullum Dr
Ste 106
Laramie, WY 82070
Phone (307) 721-2827

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2016 Change of OwnershipThis provider was the seller Enhabit Home HealthCCN 537077, WY, NPI 1952857674

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1184777625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MCCOLLUM DR",
            "address_2": "SUITE 106",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705103",
            "telephone_number": "307-721-2827",
            "fax_number": "307-742-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MCCOLLUM DR",
            "address_2": "SUITE 106",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705103",
            "telephone_number": "307-721-2827",
            "fax_number": "307-742-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT HOME HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-721-2827",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WY",
            "license": "10236",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WY",
            "license": "07 096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119002402",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119002401",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119002400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

Verify at the official NPI Registry.