NPIMap

Organization Active NPI

S&G Home Health LLC

  • Home Health Agency
  • Idaho Falls, ID
National Provider Identifier
1376088054
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
S&G HOME HEALTH LLC
Practice address
1655 1St St
Idaho Falls, ID 83401-4305
Phone
(208) 552-0249
Fax
(208) 552-6172
NPI assigned
Jan 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Authorized official

Name
Mr. Bradley J Stauffer
Title
Managing Member
Phone
(208) 552-0249

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1655 1St St
Idaho Falls, ID 83401-4305

Mailing address

1270 S Woodruff Ave
Idaho Falls, ID 83404-5544
Phone (208) 552-0249

Other names 1

  • Alliance Home Health Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170405002674 ID Part A Provider - Home Health Agency 5092091025 Practice locations: Idaho Falls, ID

Home health agency certification: CCN 137133

Legal name
S&G HOME HEALTH LLC
Doing business as
ALLIANCE HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 21, 2018
Last certification
Jun 21, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 1, 2016 in ID
Enrollment address
1655 1St St
Idaho Falls, ID 83401-4305

Care Compare: Home health agency

Medicare Care Compare
Listed as
Alliance Home Health CareCCN 137133
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jun 21, 2018
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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 numberLaboratoryCertificateExpires
13D2126133Alliance Home Health Care1655 1St Street, Idaho Falls, ID 83401Certificate of waiverFeb 20, 2027

National Provider Directory

National Provider Directory

Locations

423 Idaho St
#B
Gooding, ID 83330

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Regina Stauffer Individual General Partnership Interest Oct 1, 2019 8.87%
Hollis Murri Individual General Partnership Interest Oct 1, 2019 5.85%
North Pointe Holdings LLC Organization, Idaho Falls, ID LLC Limited Partnership Interest Oct 1, 2019 24.68%
Bradley J Stauffer Individual 5% Or Greater Direct Ownership Interest Aug 1, 2016 44.35%
Operational/Managerial Control Feb 1, 2017 44.35%

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1483488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603152000000",
    "number": "1376088054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045544",
            "telephone_number": "208-552-0249",
            "fax_number": "208-552-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1655 1ST ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834014305",
            "telephone_number": "208-552-0249",
            "fax_number": "208-552-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S&G HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-04",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A",
        "authorized_official_last_name": "STAUFFER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "208-552-0249",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alliance Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alliance Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.