Omni Home Health Care, L.L.C

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

009026 Issued in TX

Legal business name

OMNI HOME HEALTH CARE, L.L.C

Doing business as

Omni Home Health Care

Practice address

819 North O'Connor Road
Suite 101
Irving, TX 75061-6125

Phone

(972) 445-0300

Fax

(972) 445-0301

NPI assigned

Jul 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. George Koshy Alex, BS, RRT

Title

Administrator

Phone

(972) 445-0300

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• OMNI HOME HEALTH CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407889926. Details of each certification follow.

• CCN 679197 Home health agency · Active · Details

Home health agency certification: CCN 679197

Legal name

OMNI HOME HEALTH CARE, L.L.C

Doing business as

OMNI HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 20, 2002

Last certification

Dec 9, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 27, 2002 in TX

Enrollment address

819 North O'Connor Road
Suite 101
Irving, TX 75061-4510

Listed as

Omni Home Health CareCCN 679197 · All quality measures

Ownership

Proprietary

Certified

Dec 20, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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.

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407889926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 NORTH O'CONNOR ROAD",
            "address_2": "SUITE 101",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750616125",
            "telephone_number": "972-445-0300",
            "fax_number": "972-445-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 NORTH O'CONNOR ROAD",
            "address_2": "SUITE 101",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750616125",
            "telephone_number": "972-445-0300",
            "fax_number": "972-445-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HOME HEALTH CARE, L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEX",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "KOSHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-445-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS, RRT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE - DADS",
            "identifier": "009026",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1662322",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OMNI HOME HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Irving, TX
• Providers in Irving, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.