Concho Valley HHC of West TX LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

008619 Issued in TX

Legal business name

CONCHO VALLEY HHC OF WEST TX LLC

Doing business as

Concho Valley Home Health Care

Practice address

430 W Beauregard Ave Ste B
San Angelo, TX 76903

Phone

(235) 944-8916

Fax

(325) 944-8929

NPI assigned

Jul 6, 2006

Last updated

Aug 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Louise Townsend

Title

Administrator

Phone

(325) 944-8916

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Concho Valley Home Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467483362. Details of each certification follow.

• CCN 679383 Home health agency · Active · Details

Home health agency certification: CCN 679383

Legal name

CONCHO VALLEY HHC OF WEST TX LLC

Doing business as

CONCHO VALLEY HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 3, 2003

Last certification

Oct 14, 2020

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 26, 2003 in TX

Enrollment address

430 W. Beauregard Ave
Suite B
San Angelo, TX 76903-6375

Listed as

Concho Valley Home Health CareCCN 679383 · All quality measures

Ownership

Proprietary

Certified

Dec 3, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Jennifer Ann Rose, CRNP

  • Primary Care Nurse Practitioner
  • Muscle Shoals, AL
  • NPI 1720754674

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534204800000",
    "number": "1467483362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3247",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769023247",
            "telephone_number": "235-944-8916",
            "fax_number": "325-944-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W BEAUREGARD AVE STE B",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76903",
            "telephone_number": "235-944-8916",
            "fax_number": "325-944-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCHO VALLEY HHC OF WEST TX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-08-14",
        "status": "A",
        "authorized_official_last_name": "TOWNSEND",
        "authorized_official_first_name": "LOUISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "325-944-8916",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "008619",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concho Valley Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concho Valley Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Concho Valley Emergency Physicians PLLC
• Concho Valley Errand Services
• Concho Valley Family Dental
• Concho Valley Family Dental, P.a. (Dolce Vita Wellness & Dental Spa)
• Concho Valley Hematology & Oncology, PLLC
• Concho Valley Medicine, LLC
• Concho Valley Rehab, P.a.
• Kathe Ann Conner, RN/FNP BC
• Alicia Connolly, MS, MAT, LAT, ATC
• Quintin Brice Conoly, PHARMD

• Home Health Agency in San Angelo, TX
• Providers in San Angelo, 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 Aug 14, 2018; 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.