Enmed, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

ENMED, LLC

Doing business as

Quality Home Health Agency

Practice address

4375 E Lowell St Ste I
Ontario, CA 91761-2227

Phone

(909) 390-3293

Fax

(909) 390-3296

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Chandra Kelley

Title

Administrator

Phone

(909) 390-3293

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• QUALITY HOME HEALTH AGENCY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Home health agency certification: CCN 058148

Legal name

ENMED, LLC

Doing business as

QUALITY HOME HEALTH AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Nov 5, 2002

Last certification

Jan 10, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

4375E Lowell St I
Ontario, CA 91761-2227
HHA Branch

Listed as

Quality Home Health AgencyCCN 058148 · All quality measures

Ownership

Proprietary

Certified

Nov 5, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194882035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 E LOWELL ST STE I",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917612227",
            "telephone_number": "909-390-3293",
            "fax_number": "909-390-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4375 E LOWELL ST STE I",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917612227",
            "telephone_number": "909-390-3293",
            "fax_number": "909-390-3296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENMED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLEY",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "909-390-3293"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA08148F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QUALITY HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.