NPIMap

Organization Active NPI

Home Town Health Care LLC

Doing business as Home Town Home Health

  • Home Health Agency
  • Independence, KS
National Provider Identifier
1336510049
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
A06300302 Issued in KS
Legal business name
HOME TOWN HEALTH CARE LLC
Doing business as
Home Town Home Health
Practice address
921 W Myrtle St
Independence, KS 67301-3241
Phone
(620) 332-3215
Fax
(620) 332-3293
NPI assigned
Oct 8, 2015
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Mrs. Debra Rae Shinkle, RN
Title
Cheif Executive Officer
Phone
(620) 378-3760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X A06300302 KS Primary

Addresses

Primary practice location

921 W Myrtle St
Independence, KS 67301-3241

Mailing address

314 N 7TH St
Fredonia, KS 66736-1337
Phone (620) 378-3760

Other names 1

  • Home Town Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160223000961 KS Part A Provider - Home Health Agency 3375544703 Practice locations: Independence, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336510049. Details of each certification follow.

Home health agency certification: CCN 177100

Legal name
HOME TOWN HEALTH CARE LLC
Doing business as
HOME TOWN HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 14, 1982
Last certification
Jul 27, 2016
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 1, 2006 in KS
Enrollment address
921 W Myrtle St
Independence, KS 67301-3241

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Home Town Home HealthCCN 177100 · All quality measures
Ownership
Proprietary
Certified
Oct 14, 1982
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Home Town Health Care7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

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.

NameRoleSinceShare
Debra R. Shinkle Individual 5% Or Greater Direct Ownership InterestAdministrator Dec 1, 2006 50%
Corporate DirectorAdministrator Oct 11, 2015
Operational/Managerial ControlAdministrator Oct 11, 2015
OtherAdministrator Oct 11, 2015
Bobby R Shinkle Individual 5% Or Greater Direct Ownership InterestCo-Owner Dec 1, 2006 50%

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1336510049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N 7TH ST",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361337",
            "telephone_number": "620-378-3760",
            "fax_number": "620-378-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W MYRTLE ST",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013241",
            "telephone_number": "620-332-3215",
            "fax_number": "620-332-3293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME TOWN HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "SHINKLE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "620-378-3760",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KS",
            "license": "A06300302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Town Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, KS

Sources for this page

Verify at the official NPI Registry.