Regency Provider Services Inc
Organization Active NPI Home Health Agency · Parker, TX
NPI 1447453022 · NPPES record last updated Jan 22, 2019
Key facts
- NPI
- 1447453022
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 011327 (TX)
- Legal business name
- REGENCY PROVIDER SERVICES INC
- Practice address
- 7308 Forest Bend Dr
Parker, TX 75002-6817 - Phone
- (972) 922-4510
- Fax
- (469) 547-1982
- NPI assigned
- Jun 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Eziaku Jennifer Oliver, RN
- Title
- Administrator
- Phone
- (469) 547-1980
Owners & managing parties with NPI records 1
Practitioners 1
Medicare Care Compare: Home health agency
- Listed as
- Regency Home Healthcare
- Ownership
- Proprietary
- Certified
- Jul 2, 2009
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 747133
- Legal name
- REGENCY PROVIDER SERVICES INC
- Doing business as
- REGENCY HOME HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 2, 2009
- Last certification
- Jan 30, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Sep 28, 2006 in TX
- Enrollment address
- 3939 E US Hwy 80
Suite 273
Mesquite, TX 75150-8101
All disclosed owners & managing parties 1
| Name | Role | Since | Share |
|---|---|---|---|
| Eziaku Jennifer Oliver |
5% Or Greater Direct Ownership Interest | Jun 11, 2007 | |
| Corporate Director | Jun 11, 2007 | ||
| W-2 Managing Employee | Sep 28, 2006 | ||
| Operational/Managerial Control | Sep 28, 2006 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071024000041 | TX | Part a Provider - Home Health Agency | 2163518036 | Practice locations: Mesquite, TX |
National Provider Directory
Locations
3939 US Highway 80 E
Ste 273
Mesquite, TX 75150
Phone (469) 471-7839
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 011327 | TX | Yes |
| Nursing Care Agency | 251J00000X |
Addresses
Primary practice location
7308 Forest Bend Dr
Parker, TX 75002-6817
Mailing address
3939 E US Hwy 80, Suite 273
Mesquite, TX 75150-4662
Phone (469) 547-1980
Other names
- Regency Home HealthCare
Other providers in Parker, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.