NPIMap

Organization Active NPI

Elite Home Care LLC

  • Home Health Agency
  • Oklahoma City, OK
National Provider Identifier
1275590275
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELITE HOME CARE LLC
Practice address
3445 W Memorial Rd
Suite H
Oklahoma City, OK 73134
Phone
(405) 752-2523
Fax
(405) 752-2543
NPI assigned
Apr 26, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Virginia J Harbour, DPT
Title
Administrator
Phone
(405) 752-2523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3445 W Memorial Rd
Suite H
Oklahoma City, OK 73134

Mailing address

3445 W Memorial Rd
Suite H
Oklahoma City, OK 73134
Phone (405) 752-2523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070828001062 OK Part A Provider - Home Health Agency 8426069980 Practice locations: Oklahoma City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275590275. Details of each certification follow.

Home health agency certification: CCN 377628

Legal name
ELITE HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 26, 2000
Last certification
Nov 21, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 9, 2006 in OK
Enrollment address
6701 W Hefner Road
Oklahoma City, OK 73162-4701

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Home Care, LLCCCN 377628 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jan 26, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

3445 W Memorial Rd
Ste H
Oklahoma City, OK 73134
Phone (405) 752-2523

6701 W Hefner Rd
Oklahoma City, OK 73162
Phone (405) 842-1700

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
Virginia Janon Harbour Individual 5% Or Greater Direct Ownership Interest Feb 24, 2006 100%
W-2 Managing Employee May 8, 2007
Operational/Managerial ControlManager Feb 24, 2006 100%
Redwing Investments, LLC Organization, Oklahoma City, OK LLC 5% Or Greater Direct Ownership Interest Feb 24, 2006 66.67%

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275590275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 W MEMORIAL RD",
            "address_2": "SUITE H",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-752-2523",
            "fax_number": "405-752-2543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 W MEMORIAL RD",
            "address_2": "SUITE H",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73134",
            "telephone_number": "405-752-2523",
            "fax_number": "405-752-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARBOUR",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "405-752-2523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.