NPIMap

Organization Active NPI

Concierge Home Care of Lake Mary LLC

Doing business as Concierge Home Care

  • Home Health Agency
  • Heathrow, FL
National Provider Identifier
1487252185
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CONCIERGE HOME CARE OF LAKE MARY LLC
Doing business as
Concierge Home Care
Practice address
195 International Pkwy Ste 102
Heathrow, FL 32746-5071
Phone
(904) 733-1003
Fax
(904) 448-8855
NPI assigned
Oct 14, 2020
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Mr. Robert Gregory Young
Title
Secretary & Cao
Phone
(904) 733-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

195 International Pkwy Ste 102
Heathrow, FL 32746-5071

Mailing address

4655 Salisbury Rd Ste 110
Jacksonville, FL 32256-0957
Phone (904) 733-1003

Other practice location 1

4203 Vineland Rd Ste K13
Orlando, FL 32811-6627
Phone (407) 792-1213

Other identifiers 2

IdentifierTypeStateIssuer
10D2220781OtherFLCLIA
299995192OtherFLAHCA

Other names 1

  • Concierge Home Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210402000968 FL Part A Provider - Home Health Agency 8921415209 Practice locations: Heathrow, FL; Orlando, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487252185. Details of each certification follow.

Home health agency certification: CCN 687134

Legal name
CONCIERGE HOME CARE OF LAKE MARY LLC
Doing business as
CONCIERGE HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 11, 2021
Last certification
Nov 11, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 20, 2020 in FL
Enrollment address
195 International Pkwy
Ste 102
Heathrow, FL 32746-5071

Care Compare: Home health agency

Medicare Care Compare
Listed as
Concierge Home CareCCN 687134 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Nov 11, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2220781Concierge Home Care of Lake Mary LLC4203 Vineland Rd Ste K13, Orlando, FL 32811Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

195 International Pkwy
Ste 102
Heathrow, FL 32746
Phone (352) 435-0101

4203 Vineland Rd
Ste K13
Orlando, FL 32811
Phone (407) 792-1213

4401 Vineland Rd
Ste A13
Orlando, FL 32811
Phone (407) 440-2936

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 22

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Homecare Partners Holdings, LLC Organization, Jacksonville, FL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 99.21%
Heidi a Christie Individual W-2 Managing EmployeeAdministrator Feb 19, 2024
Waud Capital Partners Fif IV, L.P. Organization, Chicago, IL Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 24, 2026 23.45%
Waud Homecare Partners Holdings, LLC Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 65.54%
Jeffrey L Fisher Individual Corporate OfficerPresident Aug 20, 2020
New York State Teachers' Retirement System Organization, Albany, NY Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 6.16%
Reeve B. Waud Declaration of Trust DTD 02/21/96 Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest Apr 24, 2026 5.86%
Homecare Partners Management, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 20, 2020 100%
Homecare Partners Acquisition Co., LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 20, 2020 100%
Robert Young Individual Contracted Managing EmployeeSecretary Aug 20, 2020
Corporate OfficerSecretary Aug 20, 2020
Waud Capital Affiliates IV, LLC Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 12.14%
Homecare Partners Intermediate Holdings, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 20, 2020 100%
WCP Fif IV (Homecare Partners), L.P. Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 23.69%
David Christopher Rucker Individual Corporate OfficerChief Executive Officer Aug 20, 2020
Joseph Malone Individual Operational/Managerial ControlCfo Jun 1, 2025
Mark Hartung Individual W-2 Managing EmployeeDon Jun 10, 2024
Waud Capital Partners QP IV, L.P. Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 50.61%
WCP Fif IV Homecare Partners Blocker, Inc. Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 24, 2026 23.45%
Leeann Butchkoski Individual W-2 Managing EmployeeAlternate Admin & Alternate Don Feb 19, 2024
Jacksonville Owners Holdings, Inc. Organization, Jacksonville, FL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Aug 20, 2020 6.72%
Crescent Agency Services, LLC Organization, Boston, MA LLC, For-profit 5% Or Greater Security Interest May 25, 2021 100%
Concierge Home Care of Lake Mary Holdings, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Aug 20, 2020 100%

Facilities with the same owner 24

Facilities that share an organizational owner with 5% or greater ownership or operational control.

  • Accessrehab LLC

    dba Concierge Home Care

    • Home Health Agency
    • Jacksonville, FL
    • NPI 1891932463

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Ajl Nursing Services, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Melbourne, FL
    • NPI 1184183022

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Waud Capital Af

    CMS ownership
  • Atlantic Home Health Agency of South Florida, LLC

    dba Concierge Home Care

    • Home Health Agency
    • West Palm Beach, FL
    • NPI 1598900060

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Broward Care at Home, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Fort Lauderdale, FL
    • NPI 1326094459

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Capital Home Health, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Panama City, FL
    • NPI 1841335908

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • CHC of Gainesville, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Gainesville, FL
    • NPI 1629670310

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., Reeve B. Waud Declaration of Trust DTD 02/21/96, Waud Capit

    CMS ownership
  • CHC of Ocala LLC

    dba Concierge Home Care

    • Home Health Agency
    • Ocala, FL
    • NPI 1285236968

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Concentric Homecare, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Sarasota, FL
    • NPI 1003077066

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Waud Capital Af

    CMS ownership
  • Concierge Home Care of Jacksonville 2, LLC

    dba Concierge Home Care

    • Home Health Agency
    • Jacksonville, FL
    • NPI 1235737925

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Concierge Home Care of Lake City LLC

    dba Concierge Home Care

    • Home Health Agency
    • Lake City, FL
    • NPI 1639777345

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Concierge Home Care of Port Orange LLC

    dba Concierge Home Care

    • Home Health Agency
    • Port Orange, FL
    • NPI 1801494505

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
  • Concierge Home Care of Port St Lucie LLC

    dba Concierge Home Care

    • Home Health Agency
    • Port St Lucie, FL
    • NPI 1184222549

    Homecare Partners Acquisition Co., LLC, Homecare Partners Holdings, LLC, Homecare Partners Intermediate Holdings, LLC, Homecare Partners Management, LLC, Jacksonville Owners Holdings, Inc., New York State Teachers' Retirement System, Reeve B. Waud D

    CMS ownership
View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 47

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

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1487252185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SALISBURY RD STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560957",
            "telephone_number": "904-733-1003",
            "fax_number": "904-448-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 INTERNATIONAL PKWY STE 102",
            "city": "HEATHROW",
            "state": "FL",
            "postal_code": "327465071",
            "telephone_number": "904-733-1003",
            "fax_number": "904-448-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4203 Vineland Rd Ste K13",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328116627",
            "country_code": "US",
            "telephone_number": "407-792-1213",
            "fax_number": "352-436-0303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONCIERGE HOME CARE OF LAKE MARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "SECRETARY & CAO",
        "authorized_official_telephone_number": "904-733-1003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2220781",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "299995192",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concierge Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concierge Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Heathrow, FL

Sources for this page

Verify at the official NPI Registry.