Organization Active NPI

Nightingale Home Health LLC

  • Home Health Agency
  • North Las Vegas, NV
National Provider Identifier
1407135080
Registry record updated Jun 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
6363HHA-0 Issued in NV
Legal business name
NIGHTINGALE HOME HEALTH LLC
Practice address
1913 Broken Lance Ave
North Las Vegas, NV 89031-5090
Phone
(702) 331-5922
Fax
(702) 685-8761
NPI assigned
Aug 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2015

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

Authorized official

Name
Mr. Francis Nwabueze, RN, BSN
Title
Administrator
Phone
(702) 331-5922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 6363HHA-0 NV Primary

Addresses

Primary practice location

1913 Broken Lance Ave
North Las Vegas, NV 89031-5090

Mailing address

1913 Broken Lance Ave
North Las Vegas, NV 89031-5090
Phone (702) 331-5922

Other names 1

  • RECOVERY HOME HEALTH AGENCY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908001842 NV Part A Provider - Home Health Agency 3274703871 Practice locations: North Las Vegas, NV

Home health agency certification: CCN 297195

Legal name
NIGHTINGALE HOME HEALTH LLC
Doing business as
RECOVERY HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 31, 2012
Last certification
Dec 3, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 27, 2011 in NV
Enrollment address
1913 Broken Lance Ave
North Las Vegas, NV 89031-5090

Care Compare: Home health agency

Medicare Care Compare
Listed as
Recovery Home Health AgencyCCN 297195
Ownership
Proprietary
Certified
Mar 31, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
29D2023342Recovery Home Health Agency1913 Broken Lance Ave, North Las Vegas, NV 89031Certificate of waiverApr 19, 2027

National Provider Directory

National Provider Directory

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
Mercy Nwabueze Individual 5% Or Greater Direct Ownership InterestOwner Jul 1, 2015 50%
Corporate DirectorDirector of Nursing Jul 1, 2015 30%
Operational/Managerial ControlDirector of Nursing Jul 1, 2015
Francis Nwabueze Individual 5% Or Greater Direct Ownership InterestOwner Jul 1, 2015 50%
Corporate DirectorAdministrator Jul 1, 2015 70%
Operational/Managerial ControlAdministrator Jul 1, 2015 100%

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1313107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433808000000",
    "number": "1407135080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 BROKEN LANCE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890315090",
            "telephone_number": "702-331-5922",
            "fax_number": "702-685-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 BROKEN LANCE AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890315090",
            "telephone_number": "702-331-5922",
            "fax_number": "702-685-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIGHTINGALE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-12",
        "last_updated": "2015-06-09",
        "status": "A",
        "authorized_official_last_name": "NWABUEZE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-331-5922",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": "6363HHA-0",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RECOVERY HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.