NPIMap

Organization Active NPI

Compassionate Home Health Care, LLC

  • Home Health Agency
  • Broomfield, CO
National Provider Identifier
1215928726
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMPASSIONATE HOME HEALTH CARE, LLC
Practice address
11940 Quay St
Broomfield, CO 80020-2817
Phone
(303) 465-3700
Fax
(303) 465-2516
NPI assigned
Nov 3, 2005
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Mr. Vicki Kiesau
Title
President
Phone
(303) 465-3700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X NU
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

11940 Quay St
Broomfield, CO 80020-2817

Mailing address

11940 Quay St
Broomfield, CO 80020-2817
Phone (303) 465-3700

Other identifiers 1

IdentifierTypeStateIssuer
03439763MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050930000378 CO Part A Provider - Home Health Agency 2567497217 Practice locations: Broomfield, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1215928726. Details of each certification follow.

Home health agency certification: CCN 067459

Legal name
COMPASSIONATE HOME HEALTH CARE, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 16, 2006
Last certification
Nov 4, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 19, 2005 in CO
Enrollment address
11940 Quay St
Broomfield, CO 80020-2817

Care Compare: Home health agency

Medicare Care Compare
Listed as
Compassionate Home Health Care LLCCCN 067459 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Mar 16, 2006
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
06D1092573Compassionate Home Health Care11940 Quay St, Broomfield, CO 80020Certificate of waiverNov 27, 2026

National Provider Directory

National Provider Directory

Locations

7050 W 120th Ave
Unit 31
Broomfield, CO 80020
Phone (303) 465-3700

7050 W 120th Ave
Unit 50
Broomfield, CO 80020
Phone (303) 465-3700

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Carlos Antonio Corona Revocable Trust Organization, Broomfield, CO Created for acquisition 5% Or Greater Direct Ownership Interest Jul 23, 2021 100%
Rebecca L Fetchen Individual W-2 Managing EmployeeAdministrator Jul 23, 2021
Operational/Managerial ControlAdministrator Sep 28, 2021
Kimberly J Hightower Individual W-2 Managing EmployeeDirector of Nurses Jul 23, 2021
Vicki J Kiesau Individual Corporate OfficerPresident Jul 23, 2021
OtherTrustee Sep 28, 2021

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

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.

Affiliated clinicians 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1215928726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11940 QUAY ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202817",
            "telephone_number": "303-465-3700",
            "fax_number": "303-465-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11940 QUAY ST",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202817",
            "telephone_number": "303-465-3700",
            "fax_number": "303-465-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPASSIONATE HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "KIESAU",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-465-3700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03439763",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.