LHCG Xxix LLC
Organization Active NPI Home Health Agency · Red Bay, AL
NPI 1366740656 · NPPES record last updated Dec 17, 2019
Key facts
- NPI
- 1366740656
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- LHCG XXIX LLC
- Practice address
- 203 4TH Ave SW
Red Bay, AL 35582-4189 - Phone
- (256) 356-8160
- Fax
- (256) 356-6861
- NPI assigned
- Mar 10, 2011
- Organization subpart
- No
Authorized official
- Name
- Joshua L Proffitt
- Title
- Executive Vice President
- Phone
- (337) 233-1307
Owners & managing parties with NPI records 2
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 1
Facilities with the same owner 18
Affiliated clinicians 47
-
Timothy Dale Ashley Jr., M.D.
-
Roy Barco, M.D.
-
Kristy Lynn Crandell, M.D.
-
Paul A. Davis, M.D.
-
Hillary Jean Delarosa, M.D.
-
George A Evans, M.D.
-
Sandra Renae Evans, FNP-BC, FNP-C
-
Raynard G. Fabianke, M.D.
-
Brad M Ginevan, MD
-
Boyde J Harrison, MD
-
Don E Heinkel, M.D.
-
Jeffrey Spalding Hovater, D.O.
-
Kayla Marie Humphries, CRNP
-
Adam Dwight Isbell, M.D.
-
Bethany Ann Jackson, M.D.
-
Larry R Johnston, M.D.
-
Aaron W Karr, D.O.
Medicare Care Compare: Home health agency
- Listed as
- Keller Home Care
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Jan 20, 1994
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D1002494 | LHCG Xxix, LLC | Certificate of waiver | Aug 6, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Home health agency certification: CCN 017125
- Legal name
- LHCG XXIX, LLC
- Doing business as
- KELLER HOME CARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 20, 1994
- Last certification
- Jun 25, 2021
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Feb 17, 2011 in AL
- Enrollment address
- 203 4TH Ave SW
Red Bay, AL 35582-4189
All disclosed owners & managing parties 10
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 67% |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Apr 13, 2026 | |
| W-2 Managing Employee |
Apr 13, 2026 | ||
| Joni Babineaux |
Corporate Officer |
Apr 13, 2026 | |
| Amy Johnson |
W-2 Managing Employee |
Jun 7, 2021 | |
| Operational/Managerial Control |
Jun 7, 2021 | ||
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Apr 5, 2011 | 67% |
| Joshua Lee Proffitt |
Corporate Officer |
Aug 1, 2012 | |
| Colbert County NW Alabama Healthcare Authority |
5% Or Greater Direct Ownership Interest | Mar 24, 2011 | 33% |
| Alabama Health Care Group, LLC |
5% Or Greater Direct Ownership Interest | Mar 24, 2011 | 67% |
| Amy Cormier |
Corporate Director |
May 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110411000122 | AL | Part a Provider - Home Health Agency | 6002090438 | Practice locations: Tuscumbia, AL; Red Bay, AL |
National Provider Directory
- Tax ID family
- Alabama Hospice of the Shoals
Locations
404 Avalon Ave
Ste 102
Muscle Shoals, AL 35661
Phone (256) 314-1201
404 Avalon Ave
Ste 101
Muscle Shoals, AL 35661
Phone (256) 314-1201
116 4th Ave SE
Red Bay, AL 35582
Phone (256) 356-8160
203 4th Ave SW
Red Bay, AL 35582
Phone (256) 356-8160
1404 E Avalon Ave
Ste C
Tuscumbia, AL 35674
Phone (256) 314-1204
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
203 4TH Ave SW
Red Bay, AL 35582-4189
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other practice location 1
116 4th Ave SE
Red Bay, AL 35582-4191
Phone (256) 356-8160
Other names
- Keller Home Care
Other providers in Red Bay, AL
- Gum Creek Enterprises Inc
- HH Health System - Shoals LLC
- Kayla Marie Humphries
- Island Medical Red Bay LLC
- Keller Family Practice
- John Looney
- Luxe Aesthetics & Wellness, LLC
- Kelly Mauldin
- Chiquitta Leola Nicole McBrayer
- Medexpress Red Bay LLC
All providers in Red Bay, AL · Home Health Agency in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.