Good Shepherd Primary Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

011744 Issued in TX

Legal business name

GOOD SHEPHERD PRIMARY HEALTH CARE LLC

Practice address

7981 Mile 17 N
Edcouch, TX 78538-2096

Phone

(956) 262-7445

Fax

(956) 262-0008

NPI assigned

May 15, 2007

Last updated

Feb 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Macaria Salinas, EDD

Title

Owner Administrator

Phone

(956) 262-7445

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215143516. Details of each certification follow.

• CCN 747135 Home health agency · Active · Details

Home health agency certification: CCN 747135

Legal name

GOOD SHEPHERD PRIMARY HEALTH CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 3, 2009

Last certification

Dec 10, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Jun 21, 2007 in TX

Enrollment address

7981 Mile 17 North
Edcouch, TX 78538-7445

Listed as

Good Shepherd Primary Health Care LLCCCN 747135 · All quality measures

Ownership

Proprietary

Certified

Jun 3, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Physical therapy, Speech pathology, Occupational therapy

Tax ID family

Good Shepherd Primary Health Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Good Shepherd Primary Health Care LLC

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Edcouch, TX
  • NPI 1023844826
  NPD tax ID

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.

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Good Shepherd Primary Health Care LLC

  • Hospice and Palliative Medicine (Emergency Medicine) Physician
  • Edcouch, TX
  • NPI 1023844826
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Roxanna Rodriguez

  • Licensed Vocational Nurse
  • Edcouch, TX
  • NPI 1659872315
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549843200000",
    "number": "1215143516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7981 MILE 17 N",
            "address_2": "GOOD SHEPHERD PRIMARY HEALTH CARE LLC",
            "city": "EDCOUCH",
            "state": "TX",
            "postal_code": "785382096",
            "telephone_number": "956-262-7445",
            "fax_number": "956-262-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7981 MILE 17 N",
            "city": "EDCOUCH",
            "state": "TX",
            "postal_code": "785382096",
            "telephone_number": "956-262-7445",
            "fax_number": "956-262-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD PRIMARY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-02-11",
        "status": "A",
        "authorized_official_last_name": "SALINAS",
        "authorized_official_first_name": "MACARIA",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "956-262-7445",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "011744",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214371101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214371103",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "214371102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Julian Leija
• Clarissa Martin, OTR

• Home Health Agency in Edcouch, TX
• Providers in Edcouch, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; 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.