Public Health Home Health, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

092-207 Issued in GA

Legal business name

PUBLIC HEALTH HOME HEALTH, INC.

Practice address

1811 Green Cir
Valdosta, GA 31602-2734

Phone

(229) 253-1242

Fax

(229) 253-1151

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Denise Retterbush, RN

Title

Ceo

Phone

(229) 253-1067

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Home health agency certification: CCN 117009

Legal name

PUBLIC HEALTH HOME HEALTH, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 5, 1966

Last certification

Jul 25, 2019

Ownership / control type

Non-Profit

Organization structure

CorporationNon-profit

Incorporated

Mar 7, 1994 in GA

Enrollment address

3169 Inner Perimeter Rd
Valdosta, GA 31602-1062

Listed as

Adoration Home HealthCCN 117009

Overall star rating

1.5 of 5

Ownership

Non-Profit

Certified

Oct 5, 1966

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Locations

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.

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1285648568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3284",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316043284",
            "telephone_number": "229-253-1242",
            "fax_number": "229-253-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 GREEN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022734",
            "telephone_number": "229-253-1242",
            "fax_number": "229-253-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH HOME HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "RETTERBUSH",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-253-1067",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "092-207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00056845I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00056845B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00056845A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Valdosta, GA
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.

Verify at the official NPI Registry.