NPIMap

Organization Active NPI

Elite Home Health, LLC

  • Home Health Agency
  • Hobbs, NM
National Provider Identifier
1497788111
Registry record updated Sep 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
3226 Issued in NM
Legal business name
ELITE HOME HEALTH, LLC
Practice address
1508 N Dal Paso St
Hobbs, NM 88240-4042
Phone
(575) 393-9281
Fax
(575) 393-9332
NPI assigned
Jul 8, 2006
Last updated
Sep 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2009

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

Authorized official

Name
Mrs. Sharon Forrest, RN
Title
Administrator/Owner
Phone
(575) 393-9281

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 3226 NM Primary

Addresses

Primary practice location

1508 N Dal Paso St
Hobbs, NM 88240-4042

Mailing address

PO Box 2368
Hobbs, NM 88241-2368
Phone (575) 393-9281

Other identifiers 2

IdentifierTypeStateIssuer
66376211MedicaidNM
32D1050113OtherNMCLIA CERTIFICATE OF WAIVE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060213000094 NM Part A Provider - Home Health Agency 5496760449 Practice locations: Hobbs, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497788111. Details of each certification follow.

Home health agency certification: CCN 327198

Legal name
ELITE HOME HEALTH, LLC
Doing business as
ELITE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 27, 2006
Last certification
Aug 11, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 20, 2005 in NM
Enrollment address
1508 N Dal Paso St
Hobbs, NM 88240

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elite Home Health, LLCCCN 327198 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 27, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, 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
32D1050113Elite Home Health LLC1508 N Dal Paso Street, Hobbs, NM 88240Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory

Locations

1508 N Dal Paso St
Hobbs, NM 88240
Phone (575) 393-9281

726 E Michigan Dr
Ste 130
Hobbs, NM 88240
Phone (575) 241-1190

814 W Marland St
Hobbs, NM 88240
Phone (505) 393-9281

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Sharron Forrest Individual 5% Or Greater Direct Ownership Interest Dec 20, 2005
Corporate Director Feb 13, 2006
W-2 Managing Employee Dec 20, 2005

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1497788111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2368",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882412368",
            "telephone_number": "575-393-9281",
            "fax_number": "575-393-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1508 N DAL PASO ST",
            "city": "HOBBS",
            "state": "NM",
            "postal_code": "882404042",
            "telephone_number": "575-393-9281",
            "fax_number": "575-393-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "FORREST",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "575-393-9281",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "3226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "66376211",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE OF WAIVE",
            "identifier": "32D1050113",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hobbs, NM

Sources for this page

Verify at the official NPI Registry.