Organization Active NPI

Gracon, Inc.

Doing business as Home Bound Medical

Home Health Agency
Mountain Home, AR

National Provider Identifier

1366452633

Registry record updated Jul 1, 2020

On this page

Key facts
NPPES NPI Registry
Medicare participation
Care Compare: Home health agency
Laboratory certificates & supplier records
National Provider Directory
Ownership & related parties
NPI Registry JSON
Other providers in Mountain Home, AR
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Home Health AgencyTaxonomy code 251E00000X
License: AR4607 Issued in AR
Legal business name: GRACON, INC.
Doing business as: Home Bound Medical
Practice address: 358 Highway 5 N
Mountain Home, AR 72653-3039
Phone: (870) 425-2446
Fax: (870) 424-2223
NPI assigned: Aug 9, 2006
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jul 1, 2020

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

Authorized official

Name: Mrs. Gayla D Gray
Title: Co-Owner
Phone: (870) 425-2446

Specialties & licenses 3

Specialty (taxonomy)	Code	License	State	Primary
Case Management Agency	251B00000X
Home Health Agency	251E00000X	AR4607	AR	Primary
Nursing Care Agency	251J00000X

Addresses

Primary practice location

358 Highway 5 N
Mountain Home, AR 72653-3039

Mailing address

358 Highway 5 N
Mountain Home, AR 72653-3039
Phone (870) 425-2446

Other practice location 1

1050 Bob Courtway Dr Ste 107
Conway, AR 72032-4764
Phone (501) 504-2075

Other identifiers 14

Identifier	Type	State
140830738	Medicaid	AR
142105732	Medicaid	AR
223547797	Medicaid	AR
234439765	Medicaid	AR
164214797	Medicaid	AR
221146757	Medicaid	AR
221880732	Medicaid	AR
224179732	Medicaid	AR
187776514	Medicaid	AR
148927557	Medicaid	AR
150022765	Medicaid	AR
224181757	Medicaid	AR
218335738	Medicaid	AR
219234797	Medicaid	AR

Other names 1

Home Bound Medical Doing business as

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in AR

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20090721000585	AR	Part A Provider - Home Health Agency	0345392437	Practice locations: Mountain Home, AR

Home health agency certification: CCN 047176

Legal name: GRACON, INC.
Doing business as: HOME BOUND MEDICAL
Certification status: Active
Provider type (POS): Home health agency
Participating since: Jul 28, 2010
Last certification: Jun 6, 2018
Ownership / control type: Proprietary
Organization structure: CorporationProprietary
Incorporated: Sep 11, 2000 in AR
Enrollment address: 358 Hwy 5 North
Mountain Home, AR 72653-3039

Care Compare: Home health agency

Medicare Care Compare

Listed as: Home Bound MedicalCCN 047176 · All quality measures
Ownership: Proprietary
Certified: Jul 28, 2010
Medicare certification status: ActiveFrom the Provider of Services file
Services: Nursing, 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 number	Laboratory	Certificate	Expires
04D1107609	Home Bound Medical358 Hwy 5 North, Mountain Home, AR 72653	Certificate of waiver	Nov 8, 2027

National Provider Directory

Tax ID family: Gracon Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Gracon Inc

dba Home Bound Home Health
- Home Health Agency
- Mountain Home, AR
- NPI 1790054153
NPD tax ID

Locations

1050 Bob Courtway Dr
Ste 107
Conway, AR 72032
Phone (501) 504-2075

358 Highway 5 N
Mountain Home, AR 72653
Phone (870) 425-2446

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.

Name	Role	Since
Gayla Gray Individual	5% Or Greater Direct Ownership Interest	Jun 12, 2009
Gayla Gray Individual	W-2 Managing Employee	Oct 14, 2000
Donald Gray Individual	5% Or Greater Direct Ownership Interest	Jun 12, 2009

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1366452633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 HIGHWAY 5 N",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533039",
            "telephone_number": "870-425-2446",
            "fax_number": "870-424-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 HIGHWAY 5 N",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533039",
            "telephone_number": "870-425-2446",
            "fax_number": "870-424-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Bob Courtway Dr Ste 107",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720324764",
            "country_code": "US",
            "telephone_number": "501-504-2075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACON, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "GAYLA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "870-425-2446",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AR",
            "license": "AR4607",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "140830738",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142105732",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "223547797",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "234439765",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164214797",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221146757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "221880732",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224179732",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "187776514",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148927557",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150022765",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "224181757",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218335738",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "219234797",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Bound Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Bound Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.