Organization Active NPI

Family Care Home Health

  • Home Health Agency
  • Edmond, OK
National Provider Identifier
1306950993
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
7766 Issued in OK
Legal business name
FAMILY CARE HOME HEALTH
Practice address
865 E 33Rd St
Edmond, OK 73013-5407
Phone
(405) 842-5656
Fax
(405) 842-5658
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Authorized official

Name
Mrs. Brenda A Butler
Title
Ceo/Owner
Phone
(405) 842-5656

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 7766 OK Primary

Addresses

Primary practice location

865 E 33Rd St
Edmond, OK 73013-5407

Mailing address

865 E 33Rd St
Edmond, OK 73013-5407
Phone (405) 842-5656

Other identifiers 1

IdentifierTypeStateIssuer
200047890AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061003000065 OK Part A Provider - Home Health Agency 5799780490 Practice locations: Edmond, OK

Home health agency certification: CCN 377673

Legal name
FAMILY CARE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 10, 2004
Last certification
Feb 15, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 19, 2003 in OK
Enrollment address
865 E 33Rd St
Edmond, OK 73013-5407

Care Compare: Home health agency

Medicare Care Compare
Listed as
Family Care Home Health, IncCCN 377673
Ownership
Proprietary
Certified
Aug 10, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, 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
37D1027828Family Care Home Health Inc865 E 33Rd St, Edmond, OK 73013Certificate of waiverJun 12, 2028

National Provider Directory

National Provider Directory

Locations

865 E 33rd St
Edmond, OK 73013
Phone (405) 842-5656

4005 NW Expressway
Ste 605
Oklahoma City, OK 73116
Phone (405) 722-0047

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Brenda Butler Individual 5% Or Greater Direct Ownership Interest Nov 23, 2009
Corporate Officer Nov 17, 2003
Neola Brooks Individual Corporate Officer Nov 17, 2003
Corporate Director Nov 17, 2003
W-2 Managing Employee Nov 17, 2003
Lacretia Grant Individual Corporate Director Sep 13, 2010
W-2 Managing Employee Sep 13, 2010
Norbert Butler Individual Corporate Officer Nov 23, 2009
Corporate Director Nov 23, 2009
W-2 Managing Employee Nov 23, 2009

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1306950993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 E 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135407",
            "telephone_number": "405-842-5656",
            "fax_number": "405-842-5658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 E 33RD ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730135407",
            "telephone_number": "405-842-5656",
            "fax_number": "405-842-5658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "405-842-5656",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "7766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200047890A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.