NPIMap

Organization Active NPI

Lifecare Home Nursing, LLC

Doing business as LifeCare Health Services

  • Home Health Agency
  • Longview, TX
National Provider Identifier
1396750253
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
003475 Issued in TX
Legal business name
LIFECARE HOME NURSING, LLC
Doing business as
LifeCare Health Services
Practice address
911 W Loop 281 Ste 204
Longview, TX 75604-2934
Phone
(903) 297-9300
Fax
(903) 297-7020
NPI assigned
Jul 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Ms. Amy Wilcox
Title
Administrator / Ceo
Phone
(903) 297-9300

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 003475 TX Primary
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

911 W Loop 281 Ste 204
Longview, TX 75604-2934

Mailing address

911 W Loop 281 Ste 204
Longview, TX 75604-2934
Phone (903) 297-9300

Other identifiers 3

IdentifierTypeStateIssuer
HH168HOtherTXBLUE CROSS HOME HEALTH
5123325OtherTXAETNA HOME HEALTH
135252OtherTXGENTIVA HOME HEALTH

Other names 1

  • LifeCare Health Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111228000200 TX Part A Provider - Home Health Agency 4183898471 Practice locations: Longview, TX; Nacogdoches, TX

Home health agency certification: CCN 458393

Legal name
LIFECARE HOME NURSING, LLC
Doing business as
LIFECARE HEALTH SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 1, 1995
Last certification
Jan 7, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 20, 1995 in TX
Enrollment address
911 W Loop 281
Ste 204
Longview, TX 75604-2934

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
Lifecare Health ServicesCCN 458393 ยท All quality measures
Overall star rating
5 of 5
Ownership
Proprietary
Certified
May 1, 1995
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
Lifecare Health Services5 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.

Locations

911 W Loop 281
Ste 204
Longview, TX 75604
Phone (903) 297-9300

1901 N Stallings Dr
Ste 5
Nacogdoches, TX 75964
Phone (936) 462-1000

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.

NameRoleSinceShare
Nancy Wilcox Individual 5% Or Greater Direct Ownership InterestCeo Jan 20, 1995 51%
Corporate OfficerCeo Jan 20, 1995 51%
W-2 Managing EmployeeCeo Jan 20, 1995 51%
David Wilcox Individual 5% Or Greater Direct Ownership InterestCoo Jan 20, 1995 49%
Corporate OfficerCoo Jan 20, 1995 49%
W-2 Managing EmployeeCoo Jan 20, 1995 49%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1396750253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 W LOOP 281 STE 204",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042934",
            "telephone_number": "903-297-9300",
            "fax_number": "903-297-7020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W LOOP 281 STE 204",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042934",
            "telephone_number": "903-297-9300",
            "fax_number": "903-297-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE HOME NURSING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "WILCOX",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "ADMINISTRATOR / CEO",
        "authorized_official_telephone_number": "903-297-9300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "003475",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS HOME HEALTH",
            "identifier": "HH168H",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HOME HEALTH",
            "identifier": "5123325",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENTIVA HOME HEALTH",
            "identifier": "135252",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeCare Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LifeCare Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.