Active NPI
My Daughter's Home Health Agency LLC
Doing business as MTN Home Health
- Home Health Agency
- Show Low, AZ
National Provider Identifier
1265284202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- MY DAUGHTER'S HOME HEALTH AGENCY LLC
- Doing business as
- MTN Home Health
Mountain Home Health - Practice address
- 5300 S Sutter Dr Ste 11
Show Low, AZ 85901-8055 - Phone
- (928) 251-3181
- Fax
- (928) 251-3182
- NPI assigned
- Apr 3, 2024
- Last updated
- Jun 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Holly Pedersen
- Title
- Owner/President
- Phone
- (928) 205-3368
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | NU | Primary |
Addresses
Primary practice location
5300 S Sutter Dr Ste 11
Show Low, AZ 85901-8055
Mailing address
5300 S Sutter Dr Ste 11
Show Low, AZ 85901-8055
Phone (928) 251-3181
Other names 2
- MTN Home Health
- Mountain Home Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250115000715 | AZ | Part A Provider - Home Health Agency | 2567990872 | Practice locations: Show Low, AZ |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1265284202. Details of each certification follow.
Home health agency certification: CCN 037837
- Legal name
- MY DAUGHTERS HOME HEALTH AGENCY LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 20, 2025
- Last certification
- Mar 6, 2025
- Organization structure
- LLC
- Enrollment address
- 541 N Clark Rd
Ste a
Show Low, AZ 85901-4323
Care Compare: Home health agency
Medicare Care Compare- Listed as
- My Daughters Home Health Agency LLC
- Ownership
- -
- Certified
- Mar 20, 2025
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
5300 S Sutter Dr
Ste 11
Show Low, AZ 85901
Phone (928) 241-5861
541 N Clark Rd
Ste A
Show Low, AZ 85901
Phone (928) 205-3368
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Holly Pedersen | 5% Or Greater Direct Ownership Interest | Mar 20, 2024 | 100% |
| Corporate Director | Mar 20, 2024 | 50% | |
| W-2 Managing Employee | Mar 20, 2024 | 100% | |
| Elizabeth W Bierer | Corporate Director | Mar 20, 2024 | 50% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Practitioners & affiliated clinicians
Affiliated clinicians 7
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Sports Medicine (Orthopaedic Surgery) Physician
- Lakeside, AZ
- NPI 1477750636
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1782345600000",
"number": "1265284202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5300 S SUTTER DR STE 11",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859018055",
"telephone_number": "928-251-3181",
"fax_number": "928-251-3182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5300 S SUTTER DR STE 11",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859018055",
"telephone_number": "928-251-3181",
"fax_number": "928-251-3182"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MY DAUGHTER'S HOME HEALTH AGENCY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-03",
"last_updated": "2026-06-25",
"certification_date": "2026-06-25",
"status": "A",
"authorized_official_last_name": "PEDERSEN",
"authorized_official_first_name": "HOLLY",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "928-205-3368"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MTN Home Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mountain Home Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Show Low, AZ
- Mountain Strong Behavioral Health LLC
- Mountain View Family Practice (Clinicare)
- Edward Kraig Muder, PHARMD
- Sara Kaye Munns
- Raelynn M. Musick, N.P.
- Ginger Myers, LMFT
- N & R Bryce Enterprises LLC (White Mountain Pharmacy)
- Alok Naik, R.PH
- Nationwide Optometry P.C.
- Nationwide Optometry P.C. (Nationwide Vision)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.