NPIMap

Organization Active NPI

Fidelity Home Health Services LLC

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1225415185
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
NVS8121HHA Issued in NV
Legal business name
FIDELITY HOME HEALTH SERVICES LLC
Practice address
5250 S Pecos Rd
Suite 100B
Las Vegas, NV 89120-1289
Phone
(702) 912-4442
Fax
(702) 912-4443
NPI assigned
Apr 29, 2015
Last updated
Apr 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Maria Judita G Quano
Title
Member
Phone
(702) 912-4442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NVS8121HHA NV Primary

Addresses

Primary practice location

5250 S Pecos Rd
Suite 100B
Las Vegas, NV 89120-1289

Mailing address

5250 S Pecos Rd
Suite 100B
Las Vegas, NV 89120-1289
Phone (702) 912-4442

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150911001038 NV Part A Provider - Home Health Agency 7214244078 Practice locations: Las Vegas, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225415185. Details of each certification follow.

Home health agency certification: CCN 297217

Legal name
FIDELITY HOME HEALTH SERVICES LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 16, 2016
Last certification
Jan 11, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 20, 2013 in NV
Enrollment address
5250 S Pecos Rd
Ste 101
Las Vegas, NV 89120-1290

Care Compare: Home health agency

Medicare Care Compare
Listed as
Fidelity Home Health Services, LLCCCN 297217 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Feb 16, 2016
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
29D2114701Fidelity Home Health Services LLC5250 S Pecos Rd Ste 101, Las Vegas, NV 89120Certificate of waiverJun 19, 2028

National Provider Directory

National Provider Directory

Locations

5250 S Pecos Rd
Ste 100B
Las Vegas, NV 89120
Phone (702) 912-4442

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
Maria Ouano Individual 5% Or Greater Direct Ownership Interest Oct 8, 2015 50%
Corporate OfficerManaging Member/Coo Oct 8, 2015 50%
W-2 Managing EmployeeManaging Member Oct 8, 2015 50%
Operational/Managerial ControlManaging Member/Coo Oct 8, 2015 50%
Augustus Ouano Individual 5% Or Greater Direct Ownership Interest Oct 8, 2015 50%
Corporate OfficerManaging Member/Ceo Oct 8, 2015 50%
W-2 Managing EmployeeCeo Oct 8, 2015 50%
Operational/Managerial ControlCeo Oct 8, 2015 50%

Practitioners & affiliated clinicians

Affiliated clinicians 7

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

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1225415185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 S PECOS RD",
            "address_2": "SUITE 100B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201289",
            "telephone_number": "702-912-4442",
            "fax_number": "702-912-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 S PECOS RD",
            "address_2": "SUITE 100B",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891201289",
            "telephone_number": "702-912-4442",
            "fax_number": "702-912-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIDELITY HOME HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "QUANO",
        "authorized_official_first_name": "MARIA JUDITA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "702-912-4442"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "NVS8121HHA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.