Active NPI
At Home Nursing Care, Inc.
- In Home Supportive Care Agency
- Encinitas, CA
National Provider Identifier
1336493394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- AT HOME NURSING CARE, INC.
- Practice address
- 531 Encinitas Blvd Ste 120
Encinitas, CA 92024-3773 - Phone
- (760) 634-8000
- Fax
- (760) 634-8001
- NPI assigned
- Oct 30, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Lauren Reynolds Connelly, CMC, CHCM
- Title
- Founder/Administrator
- Phone
- (760) 634-8000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
531 Encinitas Blvd Ste 120
Encinitas, CA 92024-3773
Mailing address
531 Encinitas Blvd Ste 120
Encinitas, CA 92024-3773
Phone (760) 634-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55-9247 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190717003682 | CA | Part A Provider - Home Health Agency | 9830424530 | Practice locations: Culver City, CA; Encinitas, CA |
Home health agency certification: CCN 559247
- Legal name
- AT HOME NURSING CARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 16, 2019
- Last certification
- Dec 16, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- May 15, 2012 in CA
- Enrollment address
- 531 Encinitas Blvd
Ste 120
Encinitas, CA 92024-3773
Care Compare: Home health agency
Medicare Care Compare- Listed as
- At Home Nursing Care Inc
- Ownership
- Proprietary
- Certified
- Dec 16, 2019
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2112608 | At Home Nursing Care Inc | Certificate of waiver | May 2, 2028 |
National Provider Directory
National Provider DirectoryLocations
4260 Overland Ave
Culver City, CA 90230
Phone (310) 692-9627
Ownership & related parties
All disclosed owners & managing parties 1
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lauren Michelle Reynolds Connelly | 5% Or Greater Direct Ownership Interest | May 15, 2012 | 100% |
| W-2 Managing Employee | Apr 23, 2012 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physician Assistant
- Carlsbad, CA
- NPI 1497950208
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1667520000000",
"number": "1336493394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "531 ENCINITAS BLVD STE 120",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920243773",
"telephone_number": "760-634-8000",
"fax_number": "760-634-8001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "531 ENCINITAS BLVD STE 120",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920243773",
"telephone_number": "760-634-8000",
"fax_number": "760-634-8001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AT HOME NURSING CARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-30",
"last_updated": "2022-11-04",
"certification_date": "2022-11-04",
"status": "A",
"authorized_official_last_name": "REYNOLDS CONNELLY",
"authorized_official_first_name": "LAUREN",
"authorized_official_title_or_position": "FOUNDER/ADMINISTRATOR",
"authorized_official_telephone_number": "760-634-8000",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "CMC, CHCM"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55-9247",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.