Home Town Health Care, LLC
Organization Active NPI Home Health Agency · Fredonia, KS
NPI 1225149586 · NPPES record last updated Apr 6, 2021
Key facts
- NPI
- 1225149586
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- A103006H (KS)
- Legal business name
- HOME TOWN HEALTH CARE, LLC
- Practice address
- 314 N 7TH St
Fredonia, KS 66736-1337 - Phone
- (620) 378-3760
- Fax
- (620) 378-3765
- NPI assigned
- Aug 31, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Debra Rae Shinkle, RN
- Title
- RN Administrator
- Phone
- (620) 378-3760
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 6
Affiliated clinicians 38
-
Cy K Anderson, MD
-
Bradley Hunter Barrett, M.D.
-
Alvin D. Bird, D.O.
-
Benjamin J Cochran, APRN, DNP
-
Bryan K. Dennett, M.D.
-
Jessica L Evans, NP
-
Bryce C Heitman, DO
-
John E. Hetlinger, M.D.
-
Tonya Lynn Hill, M.D.
-
Marc A Hoffmeister, PA-C
-
Ashley Houser, D.O.
-
Anna Christine Kill, APRN
-
Anna Lasota, DO
-
Ryan Lasota, MD
-
Robert Benjamin Legler, MD, FAAP, FACP
Medicare Care Compare: Home health agency
- Listed as
- Home Town Health Care
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Apr 13, 2006
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 17D1051073 | Home Town Health Care LLC | Certificate of waiver | Feb 20, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KS
Home health agency certification: CCN 178068
- Legal name
- HOME TOWN HEALTH CARE LLC
- Doing business as
- HOME TOWN HEALTH CARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 13, 2006
- Last certification
- Dec 21, 2017
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 6, 2006 in KS
- Enrollment address
- 314 N 7TH St
Fredonia, KS 66736-1337
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Jenessa D Kleopfer |
W-2 Managing Employee |
Apr 1, 2021 | |
| Debra R. Shinkle |
5% Or Greater Direct Ownership Interest | Jan 1, 2007 | 50% |
| Operational/Managerial Control |
May 21, 2012 | ||
| Bobby R Shinkle |
5% Or Greater Direct Ownership Interest | Jan 1, 2007 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070126000489 | KS | Part a Provider - Home Health Agency | 3375544703 | Practice locations: Sedan, KS; Oswego, KS; Lyndon, KS; Emporia, KS; Fredonia, KS |
| O20101111000272 | KS | Part B Supplier - Independent Clinical Laboratory | 3375544703 | Practice locations: Fredonia, KS |
National Provider Directory
- Tax ID family
- Home Town Health Care
Locations
1642 Industrial Rd
Emporia, KS 66801
Phone (620) 342-2600
921 W Myrtle St
Independence, KS 67301
Phone (620) 331-2725
715 Washington St
Ste C
Lyndon, KS 66451
Phone (785) 310-0000
715 Washington St
Lyndon, KS 66451
Phone (785) 310-0000
113 W Main St
Sedan, KS 67361
Phone (620) 758-5082
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | A103006H | KS | Yes |
Addresses
Primary practice location
314 N 7TH St
Fredonia, KS 66736-1337
Mailing address
314 N 7TH St
Fredonia, KS 66736-1337
Phone (620) 378-3760
Other practice location 1
113 W Main St
Sedan, KS 67361-1511
Phone (620) 785-5082
Other practice location 2
1021 S Commercial St
Oswego, KS 67356-9036
Phone (620) 605-3067
Other practice location 3
1642 Industrial Rd
Emporia, KS 66801-6222
Phone (620) 342-2600
Other practice location 4
715 Washington St Ste C
Lyndon, KS 66451-9870
Phone (785) 310-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00425730B | Medicaid | KS | |
| 200425730A | Medicaid | KS | |
| 0000118441 | Other | KS | BCBSKS |
Other names
- Home Town Health Care
Other providers in Fredonia, KS
- Grene Vision Group LLC
- Handshy Medical Clinic LLC
- Handshy Medical Clinic, LLC
- Lee Ellen Heckerman
- Tonya Lynn Hill
- Jennifer Bacani McKenney, MD, LLC
- Jenessa D Kleopfer
- Terry Lea Marr
- Jennifer Bacani McKenney
- Medicalodges, Inc.
All providers in Fredonia, KS · Home Health Agency in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.