NPIMap

Organization Active NPI

Arkansas Homecare of Fulton, LLC

Doing business as Elite Home Health

  • Home Health Agency
  • Salem, AR
National Provider Identifier
1295852366
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
AR4781 Issued in AR
Legal business name
ARKANSAS HOMECARE OF FULTON, LLC
Doing business as
Elite Home Health
Practice address
110 Highway 62 W Ste 1
Salem, AR 72576-8059
Phone
(870) 895-2273
Fax
(870) 895-5515
NPI assigned
Mar 23, 2007
Last updated
Feb 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Authorized official

Name
Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AR4781 AR Primary
Nursing Care Agency 251J00000X AR4781B AR
In Home Supportive Care Agency 253Z00000X AR4781B AR

Addresses

Primary practice location

110 Highway 62 W Ste 1
Salem, AR 72576-8059

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Elite Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071213000675 AR Part A Provider - Home Health Agency 2264522242 Practice locations: Batesville, AR; Mountain Home, AR; Salem, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295852366. Details of each certification follow.

Home health agency certification: CCN 047115

Legal name
ARKANSAS HOMECARE OF FULTON, LLC
Doing business as
ELITE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 5, 1990
Last certification
Feb 14, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 22, 2007 in AR
Enrollment address
110 Highway 62 W
Ste 1
Salem, AR 72576-8059

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Home HealthCCN 047115 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Mar 5, 1990
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1068873Elite Home Health110 Highway 62 W Suite 1, Salem, AR 72576Certificate of waiverMay 21, 2027

National Provider Directory

National Provider Directory

Locations

152 Dry Kiln Rd
Batesville, AR 72501
Phone (870) 698-1413

413 Virginia Dr
Ste A
Batesville, AR 72501
Phone (870) 895-2273

330 Highway 5 N
Ste 114
Mountain Home, AR 72653
Phone (870) 425-8844

406 Highway 62 E
Mountain Home, AR 72653
Phone (870) 425-8844

501 Hospital Dr
Mountain Home, AR 72653
Phone (870) 580-0158

110 Highway 62 W
#1
Salem, AR 72576
Phone (870) 895-2273

352 Highway 62 E
#2
Salem, AR 72576
Phone (870) 895-2273

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Arkansas Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest May 1, 2007 100%
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
Brianna Shaw Individual W-2 Managing EmployeeAdministrator / Director of Nursing Feb 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest May 1, 2007 100%
Operational/Managerial Control May 1, 2007 100%
Joshua Lee Proffitt Individual Corporate OfficerExe VP / Corp Sec LHC Group Inc Aug 1, 2012

Facilities with the same owner 22

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

View all 22

Practitioners & affiliated clinicians

Affiliated clinicians 93

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1295852366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 62 W STE 1",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725768059",
            "telephone_number": "870-895-2273",
            "fax_number": "870-895-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS HOMECARE OF FULTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR4781",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AR",
            "license": "AR4781B",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AR",
            "license": "AR4781B",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elite Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, AR

Sources for this page

Verify at the official NPI Registry.