Genesis Home Healthcare, Limited Liability Company, Jackso

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GENESIS HOME HEALTHCARE, LIMITED LIABILITY COMPANY, JACKSO

Practice address

10175 Fortune Pkwy
Unit 804
Jacksonville, FL 32256-6751

Phone

(904) 204-4325

Fax

(844) 718-0076

NPI assigned

Aug 29, 2022

Organization subpart

No

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

Authorized official

Name

Ms. Claudia Caraco

Title

Owner

Phone

(904) 204-4325

Specialties & licenses 3

Addresses

Other names 1

• ORIGIN HOME HEALTH CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Home health agency certification: CCN 687323

Legal name

GENESIS HOME HEALTHCARE LIMITED LIABILITY COMPANY JACKSONVILLE

Doing business as

ORIGIN HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 25, 2024

Last certification

Apr 17, 2024

Organization structure

LLCProprietary

Incorporated

Aug 9, 2022 in FL

Enrollment address

10175 Fortune Pkwy
Unit 504
Jacksonville, FL 32256-6751

Listed as

Origin Home Health CareCCN 687323

Overall star rating

5 of 5

Ownership

-

Certified

Apr 25, 2024

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738281600000",
    "number": "1437879798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY",
            "address_2": "UNIT 804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566751",
            "telephone_number": "813-641-0500",
            "fax_number": "844-718-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY",
            "address_2": "UNIT 804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566751",
            "telephone_number": "904-204-4325",
            "fax_number": "844-718-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOME HEALTHCARE, LIMITED LIABILITY COMPANY, JACKSO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2025-01-31",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "CARACO",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-204-4325",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ORIGIN HOME HEALTH CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genesis Health Development Inc
• Genesis Health Development, Inc.
• Genesis Health Development, Inc.
• Genesis Healthcare Corporation
• Genesis Home Care and Mental Health Services
• Genesis Rehabilitation Hospital, Inc.
• Genesis Rehabilitation Hospital, Inc.
• Genesis Rehabilitation Hospital, Inc.
• Genesis Support Services
• Genesis Totalhealth and Wellness Center

• All providers in Jacksonville, FL
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.