Prevail Home Health Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PREVAIL HOME HEALTH CARE, LLC

Practice address

12803 Wirevine LN
Houston, TX 77072-2141

Phone

(281) 530-8900

Fax

(281) 530-1114

NPI assigned

May 27, 2006

Last updated

Feb 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Istmenia EllisNPI 1669177465

Title

Administrator

Phone

(281) 530-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346297199. Details of each certification follow.

• CCN 679736 Home health agency · Active · Details

Home health agency certification: CCN 679736

Legal name

PREVAIL HOME HEALTH CARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 7, 2008

Last certification

Oct 2, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 8, 2006 in TX

Enrollment address

12803 Wirevine Lane
Houston, TX 77072-2141

Listed as

Prevail Home Health Care LLCCCN 679736 · All quality measures

Overall star rating

3.5 of 5

Ownership

Proprietary

Certified

Feb 7, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Istmenia Ellis

  • Family Nurse Practitioner
  • Stafford, TX
  • NPI 1669177465
  NPD Authorized official

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1346297199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2801",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774972801",
            "telephone_number": "281-530-8900",
            "fax_number": "281-530-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12803 WIREVINE LN",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770722141",
            "telephone_number": "281-530-8900",
            "fax_number": "281-530-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVAIL HOME HEALTH CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ISTMENIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-530-8900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1976219",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.

Verify at the official NPI Registry.