NPIMap

Organization Active NPI

Johnson County Health Department

Doing business as Johnson-Magoffin County HHA

  • Home Health Agency
  • Paintsville, KY
National Provider Identifier
1265490601
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
150046 Issued in KY
Legal business name
JOHNSON COUNTY HEALTH DEPARTMENT
Doing business as
Johnson-Magoffin County HHA
Practice address
630 James Trimble Blvd
Paintsville, KY 41240
Phone
(606) 789-2596
Fax
(606) 789-3244
NPI assigned
May 3, 2006
Last updated
Apr 27, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
JOHNSON COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Daletta Campbell, RN
Title
Nurse Administrator
Phone
(606) 789-2596

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X KY150046 KY
Home Health Agency 251E00000X 150046 KY Primary
Community/Behavioral Health Agency 251S00000X KY150046 KY

Addresses

Primary practice location

630 James Trimble Blvd
Paintsville, KY 41240

Mailing address

630 James Trimble Blvd
Paintsville, KY 41240
Phone (606) 789-2596

Other identifiers 4

IdentifierTypeStateIssuer
45344140OtherKYEPSDT
1265490601OtherKYNPI
34002584MedicaidKY
42005819OtherKYHCBW

Other names 1

  • JOHNSON-MAGOFFIN COUNTY HHA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120131000599 KY Part A Provider - Home Health Agency 4587652722 Practice locations: Paintsville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265490601. Details of each certification follow.

Home health agency certification: CCN 187054

Legal name
JOHNSON COUNTY HEALTH DEPARTMENT
Doing business as
JOHNSON-MAGOFFIN COUNTY HHA
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 4, 1974
Last certification
Jan 31, 2018
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Enrollment address
630 James Trimble Blvd
Paintsville, KY 41240-1026
HHA Branch

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Johnson-Magoffin Home Health AgencyCCN 187054 · All quality measures
Overall star rating
4.5 of 5
Ownership
Non-Profit
Certified
Dec 4, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Paintsville High School12 organizations share this tax ID, including this one
Part of
Paintsville High School

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

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
Julie Bush Individual Corporate DirectorPublic Health Director Jul 21, 2014 100%
Lora Stepp Individual Operational/Managerial ControlNurse Administrator Aug 1, 2023

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 9

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": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1265490601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 JAMES TRIMBLE BLVD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "41240",
            "telephone_number": "606-789-2596",
            "fax_number": "606-789-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 JAMES TRIMBLE BLVD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "41240",
            "telephone_number": "606-789-2596",
            "fax_number": "606-789-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHNSON COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2006-05-03",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "DALETTA",
        "authorized_official_title_or_position": "NURSE ADMINISTRATOR",
        "authorized_official_telephone_number": "606-789-2596",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "KY",
            "license": "KY150046",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KY",
            "license": "150046",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "KY",
            "license": "KY150046",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPSDT",
            "identifier": "45344140",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265490601",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34002584",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCBW",
            "identifier": "42005819",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JOHNSON-MAGOFFIN COUNTY HHA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paintsville, KY

Sources for this page

Verify at the official NPI Registry.