Champion Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

004883 Issued in TX

Legal business name

CHAMPION CARE, INC

Practice address

1419 Market St
Laredo, TX 78040

Phone

(956) 712-2156

Fax

(956) 727-7861

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Yolinda Trevino, RN

Title

Director/Ceo/Cfo

Phone

(956) 718-2777

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 459052

Legal name

CHAMPION CARE, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 20, 1996

Last certification

Jun 27, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Sep 20, 1995 in TX

Enrollment address

1419 Market Street
Laredo, TX 78040-8841

Listed as

Champion Care, Inc.CCN 459052 · All quality measures

Ownership

Proprietary

Certified

Dec 20, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

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

CLIA laboratory certificates

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1447283270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 MARKET ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780408841",
            "telephone_number": "956-712-2156",
            "fax_number": "956-727-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 MARKET ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "78040",
            "telephone_number": "956-712-2156",
            "fax_number": "956-727-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "YOLINDA",
        "authorized_official_title_or_position": "DIRECTOR/CEO/CFO",
        "authorized_official_telephone_number": "956-718-2777",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "004883",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024195201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kassandra Lynn Cervera, RPH
• Alessandra Mariel Chacon, DDS,MS
• Chad E. Sims, D.C., P.C. (Sims Chiropractic Center)
• Marla Fabiola Chaires, FNP
• Nikit Chalise
• Champion Palomita Services Inc (Champion Palomita Services)
• Champion Tele-Health Services LLC (Champion Tele-Health Services)
• Champion Telehealth Services Inc (Champion TeleHealth Services)
• Iliana Medina Chandarlis, DPT
• Chanderbhan Psychological Services PLLC

• Home Health Agency in Laredo, TX
• Providers in Laredo, 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 Apr 12, 2019; 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.