NPIMap

Organization Active NPI

Northeast Plains Home Health Care, LLC

  • Home Health Agency
  • Sterling, CO
National Provider Identifier
1194832196
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
NORTHEAST PLAINS HOME HEALTH CARE, LLC
Practice address
731 W. Main
Sterling, CO 80751
Phone
(970) 522-3045
Fax
(970) 522-3047
NPI assigned
Aug 24, 2006
Last updated
Aug 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Authorized official

Name
Mr. Mark I. McDonald, PHYSICAL THERAPIST
Title
Owner, PT
Phone
(970) 522-3045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

731 W. Main
Sterling, CO 80751

Mailing address

P.O. Box 789
Sterling, CO 80751
Phone (970) 522-3045

Other identifiers 1

IdentifierTypeStateIssuer
25478028MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051027000388 CO Part A Provider - Home Health Agency 0446277644 Practice locations: Sterling, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194832196. Details of each certification follow.

Home health agency certification: CCN 067460

Legal name
NORTHEAST PLAINS HOME HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 30, 2006
Last certification
Mar 3, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 13, 2005 in CO
Enrollment address
731W Main St
Sterling, CO 80751-2921

Care Compare: Home health agency

Medicare Care Compare
Listed as
Northeast Plains Home Health Care LLCCCN 067460 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Mar 30, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Northeast Plains Home Health Care LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

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.

NameRoleSinceShare
Mark Irvin McDonald Individual 5% Or Greater Direct Ownership Interest Nov 26, 2019 51%
Corporate OfficerPresident Nov 26, 2019
W-2 Managing Employee Nov 15, 2019
Rose McDonald Individual 5% Or Greater Direct Ownership Interest Nov 26, 2019 49%
Corporate OfficerVice President Nov 26, 2019
W-2 Managing Employee Nov 26, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566518400000",
    "number": "1194832196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 789",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "80751",
            "telephone_number": "970-522-3045",
            "fax_number": "970-522-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 W. MAIN",
            "city": "STERLING",
            "state": "CO",
            "postal_code": "80751",
            "telephone_number": "970-522-3045",
            "fax_number": "970-522-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PLAINS HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2019-08-23",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "970-522-3045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25478028",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling, CO

Sources for this page

Verify at the official NPI Registry.