NPIMap

Organization Active NPI

Terrace Home Health Springfield, LLC

Doing business as Terrace Home Health

  • Home Health Agency
  • Springfield, MO
National Provider Identifier
1285291575
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TERRACE HOME HEALTH SPRINGFIELD, LLC
Doing business as
Terrace Home Health
Practice address
4650 S National Ave Ste D2
Springfield, MO 65810-2896
Phone
(417) 766-3536
NPI assigned
May 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Kelly Snowball
Title
Governing Body Chair
Phone
(801) 397-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

4650 S National Ave Ste D2
Springfield, MO 65810-2896

Mailing address

598 W 900 S Ste 220
Woods Cross, UT 84010-8195
Phone (801) 397-4697

Other names 1

  • Terrace Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191003000065 MO Part A Provider - Home Health Agency 9830429901 1 other NPI on this enrollment
Practice locations: Springfield, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285291575. Details of each certification follow.

Home health agency certification: CCN 267672

Legal name
TERRACE HOME HEALTH SPRINGFIELD LLC
Doing business as
TERRACE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 23, 2020
Last certification
Jan 23, 2020
Ownership / control type
Proprietary
Organization structure
LLC
Incorporated
Apr 2, 2019 in ID
Enrollment address
4650 S National Ave
Ste D2
Springfield, MO 65810-2896
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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Terrace Home HealthCCN 267672 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Jan 23, 2020
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

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Edward L Bangerter Individual 5% Or Greater Indirect Ownership InterestLLC Member DLB Legacy LLC Mar 28, 2025 17.64%
Gary J Stevens Individual Corporate OfficerVice President Apr 1, 2025
Operational/Managerial ControlMember Board of Managers Apr 1, 2025
Dee R Bangerter Individual 5% Or Greater Indirect Ownership InterestGrantor DLB Legacy LLC Mar 28, 2025 15.71%
BV Operations LLC. Organization, Idaho Falls, ID LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 28, 2025 22.84%
Allen L Ball Individual 5% Or Greater Indirect Ownership InterestGrantor Ball Ventures LLC Jan 16, 2001 11.42%
RMC Enterprises LLC Organization, Woods Cross, UT LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2025 100%
Connie L Ball Individual 5% Or Greater Indirect Ownership InterestGrantor Ball Ventures LLC Jan 16, 2001 11.42%
Jennifer Weiner Individual W-2 Managing EmployeeAd; May 1, 2024 100%
DLB Legacy LLC Organization, Woods Cross, UT LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 77.16%
Johnathan Bangerter Individual 5% Or Greater Indirect Ownership InterestMember & Trustee DLB Legacy LLC Mar 28, 2025 34.66%
Jason Gatherum Individual Corporate OfficerPresident Apr 1, 2025
Operational/Managerial ControlPresident & Cdo Apr 1, 2025
BV Pac Holdings LLC Organization, Idaho Falls, ID LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 1, 2025 22.84%
Kelly Snowball Individual Corporate OfficerGoverning Body Chair Apr 1, 2025
Ball Ventures LLC Organization, Idaho Falls, ID LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 2, 2005 22.84%
Richard P Shrader Individual 5% Or Greater Indirect Ownership InterestTrustee DLB Legacy LLC Mar 28, 2025 8.11%

Facilities with the same owner 6

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

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 5

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": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1285291575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 W 900 S STE 220",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840108195",
            "telephone_number": "801-397-4697",
            "fax_number": "801-296-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 S NATIONAL AVE STE D2",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658102896",
            "telephone_number": "417-766-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRACE HOME HEALTH SPRINGFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "SNOWBALL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "GOVERNING BODY CHAIR",
        "authorized_official_telephone_number": "801-397-4000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Terrace Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.