Companion Home Health, LLC

Organization Active NPI Home Health Agency · Guthrie, OK

NPI 1245233170 · NPPES record last updated Dec 15, 2016

Key facts

NPI
1245233170
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
7790 (OK)
Legal business name
COMPANION HOME HEALTH, LLC
Practice address
1310 E Oklahoma Ave
Guthrie, OK 73044-3757
Phone
(405) 282-3402
Fax
(405) 282-3421
NPI assigned
May 24, 2005
Organization subpart
No

Authorized official

Name
Mrs. Donna Bennett, RN, CHCA
Title
Administrator
Phone
(405) 293-9000

Facilities with the same owner 1

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

Practitioners 1

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

Affiliated clinicians 21

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

Medicare Care Compare: Home health agency

Listed as
Companion Home Health, LLC CCN 377683
Overall star rating
★★★☆☆ 3 of 5
Ownership
Proprietary
Certified
Jan 6, 2005
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

Home health agency certification: CCN 377683

Legal name
COMPANION HOME HEALTH, LLC
Doing business as
COMPANION HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 6, 2005
Last certification
Aug 7, 2019
Ownership / control type
Proprietary
Organization structure
LLC · Proprietary
Incorporated
Jun 23, 2004 in OK
Enrollment address
1310E Oklahoma Ave
Guthrie, OK 73044-3757

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Tandie D Hastings
Individual
Corporate Officer
Mmanaging Member
Jun 7, 2018 5%
Josh Chappell
Individual
W-2 Managing Employee
Ad;
Jun 1, 2024
Operational/Managerial Control Jun 6, 2018 95%
Jeffery W Chappell
Individual
5% Or Greater Indirect Ownership Interest Aug 1, 2018 51%
General Partnership Interest Oct 16, 2004 51%
Deborah Chappell
Individual
5% Or Greater Indirect Ownership Interest Aug 1, 2018 49%
General Partnership Interest Jan 18, 2008 49%
JDC LLC
Organization · Guthrie, OK
LLC
5% Or Greater Direct Ownership Interest Aug 1, 2018 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20041006000360 OK Part a Provider - Home Health Agency 5698734606 Practice locations: Edmond, OK; Guthrie, OK

National Provider Directory

Locations

1310 E Oklahoma Ave
Guthrie, OK 73044
Phone (405) 282-1686

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7790 OK Yes

Addresses

Primary practice location

1310 E Oklahoma Ave
Guthrie, OK 73044-3757

Mailing address

1310 E Oklahoma Ave
Guthrie, OK 73044-3757
Phone (405) 293-9000

Other identifiers

IdentifierTypeStateIssuer
000377683001OtherOKBLUE CROSS BLUE SHIELD
200049690 AMedicaidOK

Other providers in Guthrie, OK

All providers in Guthrie, OK · Home Health Agency in Oklahoma

Sources for this page

Verify at the official NPI Registry.