Organization Active NPI

At Home Nursing Care, Inc.

  • In Home Supportive Care Agency
  • Encinitas, CA
National Provider Identifier
1336493394
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
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

Updated by the provider on Nov 4, 2022

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
55-9247MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
Incorporated
May 15, 2012 in CA
Enrollment address
531 Encinitas Blvd
Ste 120
Encinitas, CA 92024-3773
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
At Home Nursing Care IncCCN 559247 · All quality measures
Ownership
Proprietary
Certified
Dec 16, 2019
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
05D2112608At Home Nursing Care Inc531 Encinitas Blvd Suite 120, Encinitas, CA 92024Certificate of waiverMay 2, 2028

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Lauren Michelle Reynolds Connelly Individual 5% Or Greater Direct Ownership InterestFounder/Administrator May 15, 2012 100%
W-2 Managing EmployeeAdministrator Apr 23, 2012 100%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "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

Verify at the official NPI Registry.