NPIMap

Organization Active NPI

Providence Home Care Agency Inc.

  • Home Health Agency
  • Emmaus, PA
National Provider Identifier
1215218920
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
21583601 Issued in PA
Legal business name
PROVIDENCE HOME CARE AGENCY INC.
Practice address
29 N 4TH St
Emmaus, PA 18049-2745
Phone
(610) 421-8623
Fax
(610) 340-2940
NPI assigned
Sep 8, 2011
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Michael Anthony Frazer
Title
Administrator
Phone
(610) 421-8623

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 21583601 PA Primary

Addresses

Primary practice location

29 N 4TH St
Emmaus, PA 18049-2745

Mailing address

PO Box 464
Emmaus, PA 18049-0464
Phone (610) 421-8623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120620000658 PA Part A Provider - Home Health Agency 4688838790 Practice locations: Emmaus, PA; Morgantown, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215218920. Details of each certification follow.

Home health agency certification: CCN 398186

Legal name
PROVIDENCE HOME CARE AGENCY INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 21, 2012
Last certification
Jan 28, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Apr 18, 2011 in PA
Enrollment address
29 N 4TH St
Emmaus, PA 18049-2745

Care Compare: Home health agency

Medicare Care Compare
Listed as
Providence Home Health Agency, Inc.CCN 398186 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Aug 21, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Providence Home Care Agency Inc2 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

151 Main St
Ste A
Emmaus, PA 18049
Phone (610) 421-8900

222 Main St
Rear
Emmaus, PA 18049

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
Avie Ann Laing Individual Corporate DirectorAdministrator Jun 1, 2024
W-2 Managing EmployeeAd; Jun 1, 2024 100%
Michael a Frazer Individual 5% Or Greater Direct Ownership InterestCeo Apr 1, 2010 100%
W-2 Managing EmployeeAdministrator Apr 1, 2010 100%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Everyday Home Care LLCBethlehem, PA, CCN 398236 Home health agency 5% Or Greater Security Interest (50%) Oct 11, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1215218920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 464",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180490464",
            "telephone_number": "610-421-8623",
            "fax_number": "610-340-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N 4TH ST",
            "city": "EMMAUS",
            "state": "PA",
            "postal_code": "180492745",
            "telephone_number": "610-421-8623",
            "fax_number": "610-340-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME CARE AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-08",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "FRAZER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-421-8623"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "21583601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmaus, PA

Sources for this page

Verify at the official NPI Registry.