Omni Home Health - Jacksonville, LLC
Organization Active NPI Home Health Agency · Orange City, FL
NPI 1467446203 · NPPES record last updated Jun 13, 2023
Key facts
- NPI
- 1467446203
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 299991616 (FL)
- Legal business name
- OMNI HOME HEALTH - JACKSONVILLE, LLC
- Practice address
- 2765 Rebecca LN Ste a&B
Orange City, FL 32763-8326 - Phone
- (386) 775-0164
- Fax
- (386) 775-0760
- NPI assigned
- Sep 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Joshua L. Proffitt
- Title
- President
- Phone
- (337) 233-1307
Corporate family (same tax ID) 1
Facilities with the same owner 111
Practitioners 2
-
Daniel Galicia, PT
-
Anita Reyes, PT
Affiliated clinicians 14
-
Frank Roman Avilucea, M.D.
-
Tiffany Gaskins, APRN
-
Tori Hartmann, FNP-C
-
De'la Johnson, NURSE PRACTITIONER
-
Jesse Wayne Johnson Jr., M.D.
-
Dianne Kyle, ARNP
-
Kale Meeks, DPM
-
Danielle Renee Miller, AGACNP
-
Steven Shinn, M.D.
-
Saijai Sonia Remy, APRN-BC
Medicare Care Compare: Home health agency
- Listed as
- Apex Home Healthcare
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- May 23, 2002
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1003373 | Omni Home Health-Jacksonville Dba | Certificate of waiver | Aug 27, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Home health agency certification: CCN 107707
- Legal name
- OMNI HOME HEALTH - JACKSONVILLE, LLC
- Doing business as
- APEX HOME HEALTHCARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 23, 2002
- Last certification
- Apr 14, 2021
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 2, 2001 in FL
- Enrollment address
- 2765 Rebecca LN
Ste a&B
Orange City, FL 32763-8326
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 100% |
| Audra Bishop |
W-2 Managing Employee |
Oct 16, 2023 | |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Feb 22, 2023 | |
| Omni Home Health Services LLC |
5% Or Greater Direct Ownership Interest | Jan 1, 2018 | 100% |
| Omni Home Health Holdings Inc |
5% Or Greater Indirect Ownership Interest | Jan 1, 2018 | 100% |
| Melissa Herlehy |
W-2 Managing Employee |
Oct 16, 2023 | |
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Apr 1, 2018 | 100% |
| Joshua Lee Proffitt |
Corporate Officer |
Apr 30, 2018 | |
| Almost Family, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 7, 2013 | 100% |
| National Health Industries, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 7, 2013 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050316000451 | FL | Part a Provider - Home Health Agency | 1557316106 | Practice locations: Orange City, FL |
National Provider Directory
- Tax ID family
- Apex Home Healthcare
Locations
3890 Dunn Ave
Ste 102
Jacksonville, FL 32218
Phone (904) 924-1374
3890 Dunn Ave
Ste 103
Jacksonville, FL 32218
Phone (904) 924-1374
9143 Philips Hwy
Ste 195
Jacksonville, FL 32256
Phone (904) 519-9233
9143 Philips Hwy
Ste 170
Jacksonville, FL 32256
Phone (904) 353-2019
2765 Rebecca Ln
Ste Ab
Orange City, FL 32763
Phone (386) 775-0164
4475 US Highway 1 S
Ste 202
Saint Augustine, FL 32086
Phone (904) 494-0210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 299991616 | FL | Yes |
Addresses
Primary practice location
2765 Rebecca LN Ste a&B
Orange City, FL 32763-8326
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004729500 | Medicaid | FL |
Other names
- Apex Home Healthcare
Other providers in Orange City, FL
- Vanessa Odriozola
- Kevin Samuel Rohan Ogle
- Godson Ifeanyi Oguchi
- Brian Olejniczak
- Kaylie Nicole Oltorik
- Optimal Healthcare Physical Medicine Inc
- Optimal Research Sites, LLC
- Optimal Wellness Redefined, LLC
- Orange City Anesthesia Services LLC
- Orange City Community Pharmacy
All providers in Orange City, FL · Home Health Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 13, 2023. 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.