Organization Active NPI

SD Home Care LLC

  • Home Health Agency
  • Omaha, NE
National Provider Identifier
1235911314
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SD HOME CARE LLC
Practice address
5094 S 108TH St
Omaha, NE 68137-2314
Phone
(531) 777-8859
NPI assigned
Oct 16, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
Mr. Tyrone ShieldsNPI 1114688686
Title
Owner
Phone
(402) 707-0909

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Home Health Agency 251E00000X Primary
Transportation Network Company 342000000X
Transportation Broker 347E00000X
Home Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SH0200X
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X

Addresses

Primary practice location

5094 S 108TH St
Omaha, NE 68137-2314

Mailing address

15130 Bauman Ave
Omaha, NE 68116-4475
Phone (402) 707-0909

National Provider Directory

National Provider Directory

Locations

5094 S 108th St
Omaha, NE 68137
Phone (531) 777-8859

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1235911314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15130 BAUMAN AVE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681164475",
            "telephone_number": "402-707-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5094 S 108TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681372314",
            "telephone_number": "531-777-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SD HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "SHIELDS",
        "authorized_official_first_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-707-0909",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.