Holdenville Home Health, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

377448 Issued in OK

Legal business name

HOLDENVILLE HOME HEALTH, LLC

Practice address

711 N Bullitt St
Suite B
Holdenville, OK 74848-3804

Phone

(405) 379-2300

Fax

(405) 379-2309

NPI assigned

Jun 11, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Marsha L. Mathis

Title

Office Manager

Phone

(405) 379-2300

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• A Path of Care Home Health III, LLC

  • Home Health Agency
  • Yukon, OK
  • NPI 1649611278

  Sold to, 2016-02-29

  CMS change of ownership

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1427090851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 N BULLITT ST",
            "address_2": "SUITE B",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748483804",
            "telephone_number": "405-379-2300",
            "fax_number": "405-379-2309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 N BULLITT ST",
            "address_2": "SUITE B",
            "city": "HOLDENVILLE",
            "state": "OK",
            "postal_code": "748483804",
            "telephone_number": "405-379-2300",
            "fax_number": "405-379-2309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLDENVILLE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "MATHIS",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "405-379-2300",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "OK",
            "license": "377448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100699880D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS #",
            "identifier": "000377448001",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Ione Hartwick, PRSS
• Haskell Regional Hospital, Inc.
• Heritage Village Nursing Center LLC
• Holdenvile Clinic and Urgent Care LLC
• Holdenville Eye Center PLLC
• Holdenville Hospital Authority
• Holdenville Hospital Authority
• Holdenville Hospital Authority
• Holdenville Hospital Authority
• Holdenville Public Schools

• Home Health Agency in Holdenville, OK
• Providers in Holdenville, OK by specialty
• Home Health Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.