NPIMap

Organization Active NPI

Family Home Care Corporation

  • Home Health Agency
  • Liberty Lake, WA
National Provider Identifier
1275536757
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IS280 Issued in WA
Legal business name
FAMILY HOME CARE CORPORATION
Practice address
22820 E Appleway
Liberty Lake, WA 99019-9514
Phone
(509) 473-4900
Fax
(509) 755-4974
NPI assigned
May 27, 2005
Last updated
Jan 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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

Authorized official

Name
Mr. Jeffrey R Kolcum, CPA
Title
Chief Financial Officer
Phone
(509) 473-4900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IS281 WA
Home Health Agency 251E00000X IS280 WA Primary

Addresses

Primary practice location

22820 E Appleway
Liberty Lake, WA 99019-9514

Mailing address

22820 E Appleway
Liberty Lake, WA 99019-9514
Phone (509) 473-4900

Other identifiers 9

IdentifierTypeStateIssuer
9050949MedicaidWA
9052200MedicaidWA
7408065MedicaidWA
1128OtherWAPREMERA PVT INSURANCE
147269OtherWALABOR & INDUSTRIES
5090FAOtherWAREGENCE PVT INSURANCE
7330095MedicaidWA
119038MedicaidWA
9055120MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Jacqueline Wagner65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232323200000",
    "number": "1275536757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22820 E APPLEWAY",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199514",
            "telephone_number": "509-473-4900",
            "fax_number": "509-755-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22820 E APPLEWAY",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990199514",
            "telephone_number": "509-473-4900",
            "fax_number": "509-755-4974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HOME CARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2009-01-19",
        "status": "A",
        "authorized_official_last_name": "KOLCUM",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "509-473-4900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS281",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IS280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9050949",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9052200",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7408065",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA PVT INSURANCE",
            "identifier": "1128",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "147269",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PVT INSURANCE",
            "identifier": "5090FA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7330095",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119038",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9055120",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; 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.