NPIMap

Organization Active NPI

LHCG Xvii, LLC

Doing business as Idaho Home Health & Hospice

  • Home Health Agency
  • Twin Falls, ID
National Provider Identifier
1356669675
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG XVII, LLC
Doing business as
Idaho Home Health & Hospice
Practice address
722 N College Rd Ste 150
Twin Falls, ID 83301-6487
Phone
(208) 734-4061
Fax
(208) 734-3471
NPI assigned
May 11, 2010
Last updated
Oct 10, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

722 N College Rd Ste 150
Twin Falls, ID 83301-6487

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Idaho Home Health & Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100719000417 ID Part A Provider - Home Health Agency 8426180977 Practice locations: Meridian, ID; Twin Falls, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356669675. Details of each certification follow.

Home health agency certification: CCN 137014

Legal name
LHCG XVII, LLC
Doing business as
IDAHO HOME HEALTH & HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 1, 1977
Last certification
Mar 12, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 22, 2010 in ID
Enrollment address
722 N College Rd
Ste 150
Twin Falls, ID 83301-3485

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Idaho Home Health & HospiceCCN 137014 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jun 1, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Idaho Home Care Supply5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCoo Apr 13, 2026
W-2 Managing EmployeeCoo Apr 13, 2026
Joni Babineaux Individual Corporate OfficerCfo Apr 13, 2026
Amanda Torres Individual W-2 Managing EmployeeAd; Feb 19, 2024
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2010 100%
Operational/Managerial Control Jul 1, 2010 100%
Idaho Health Care Group, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Jul 1, 2010 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Aug 1, 2012
Amy Cormier Individual Corporate DirectorDirector of Managed Care May 1, 2025

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 35

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1356669675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 N COLLEGE RD STE 150",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833016487",
            "telephone_number": "208-734-4061",
            "fax_number": "208-734-3471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG XVII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Idaho Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Idaho Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.