Active NPI
Alpine Management Enterprises Inc.
- Home Health Agency
- Elk Grove, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- ALPINE MANAGEMENT ENTERPRISES INC.
- Doing business as
- Alpine Home Health Agency
- Practice address
- 2368 Maritime Dr
Elk Grove, CA 95758-3652 - Phone
- (916) 312-6001
- NPI assigned
- Sep 20, 2017
- 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
- Amanda Moore, PMHNP-BC
- Title
- Administrator
- Phone
- (916) 713-7071
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X |
Addresses
Primary practice location
2368 Maritime Dr
Elk Grove, CA 95758-3652
Mailing address
9245 Laguna Springs Dr Ste 200
Elk Grove, CA 95758-7991
Phone (916) 713-7071
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6508546088 | Other | LEGACY NUMBERS |
Other names 1
- Alpine Home Health Agency
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180620000012 | CA | Part A Provider - Home Health Agency | 9436404241 | Practice locations: Elk Grove, CA |
Home health agency certification: CCN 757001
- Legal name
- ALPINE MANAGEMENT ENTERPRISES INC.
- Doing business as
- ALPINE HOME HEALTH AGENCY
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 12, 2022
- Last certification
- Jul 12, 2022
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Feb 16, 2010 in CA
- Enrollment address
- 2368 Maritime Dr
Ste 240
Elk Grove, CA 95758-3655
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Alpine Home Health Agency
- Ownership
- Proprietary
- Certified
- Jul 12, 2022
- 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 |
|---|---|---|---|
| 05D2165852 | Alpine Management Enterprises Inc | Certificate of waiver | May 6, 2027 |
National Provider Directory
National Provider DirectoryLocations
2368 Maritime Dr
Ste 240
Elk Grove, CA 95758
Phone (916) 312-6001
2368 Maritime Dr
Elk Grove, CA 95758
Phone (916) 312-6001
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 |
|---|---|---|---|
| Roy Jonathan Williams | Operational/Managerial Control | Jan 6, 2023 | 100% |
| Alex Novell | 5% Or Greater Direct Ownership Interest | Feb 16, 2010 | 50% |
| Corporate Officer | Feb 16, 2010 | 50% | |
| Natalya Novosyolov | 5% Or Greater Direct Ownership Interest | Feb 16, 2010 | 50% |
| Corporate Officer | Feb 16, 2010 | 50% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Pasadena, CA
- NPI 1184555377
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775520000000",
"number": "1194234351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9245 LAGUNA SPRINGS DR STE 200",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957587991",
"telephone_number": "916-713-7071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2368 MARITIME DR",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957583652",
"telephone_number": "916-312-6001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALPINE MANAGEMENT ENTERPRISES INC.",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-20",
"last_updated": "2026-04-07",
"certification_date": "2026-04-07",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "AMANDA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "916-713-7071",
"authorized_official_credential": "PMHNP-BC"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LEGACY NUMBERS",
"identifier": "6508546088",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Alpine Home Health Agency",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.