Organization Active NPI

Alpine Management Enterprises Inc.

  • Home Health Agency
  • Elk Grove, CA
National Provider Identifier
1194234351
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Amanda Moore, PMHNP-BCNPI 1184555377
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)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
6508546088OtherLEGACY NUMBERS

Other names 1

  • Alpine Home Health Agency Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 AgencyCCN 757001 · All quality measures
Ownership
Proprietary
Certified
Jul 12, 2022
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
05D2165852Alpine Management Enterprises Inc2368 Maritime Dr Ste 240, Elk Grove, CA 95758Certificate of waiverMay 6, 2027

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Roy Jonathan Williams Individual Operational/Managerial ControlAdmin Designee / DPCS Designee Jan 6, 2023 100%
Alex Novell Individual 5% Or Greater Direct Ownership InterestOwner Feb 16, 2010 50%
Corporate OfficerOwner Feb 16, 2010 50%
Natalya Novosyolov Individual 5% Or Greater Direct Ownership InterestOwner Feb 16, 2010 50%
Corporate OfficerOwner 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.

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

Verify at the official NPI Registry.