NPIMap

Organization Active NPI

The University of Texas Southwestern Medical Center at Dallas

Doing business as UT Southwestern Home Health Care

  • Home Health Agency
  • Dallas, TX
National Provider Identifier
1508921313
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
009569 Issued in TX
Legal business name
THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Doing business as
UT Southwestern Home Health Care
Practice address
6333 Forest Park Road
Suite BLB 304
Dallas, TX 75390-9279
Phone
(214) 645-4570
Fax
(214) 645-4578
NPI assigned
Dec 22, 2006
Last updated
Nov 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Authorized official

Name
Mr. John A Roan
Title
Executive Vice President for Busine
Phone
(214) 645-4570

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 009569 TX Primary
Transportation Broker 347E00000X

Addresses

Primary practice location

6333 Forest Park Road
Suite BLB 304
Dallas, TX 75390-9279

Mailing address

PO Box 36423
Dallas, TX 75235-9662
Phone (214) 645-4570

Other identifiers 1

IdentifierTypeStateIssuer
TPI175252901MedicaidTX

Other names 1

  • UT Southwestern Home Health Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.offceally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Bluemark LLC/Office Ally

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050131000171 TX Part A Provider - Home Health Agency 7214987957 Practice locations: Dallas, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508921313. Details of each certification follow.

Home health agency certification: CCN 678078

Legal name
THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS
Doing business as
UT SOUTHWESTERN HOME HEALTH CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 26, 1995
Last certification
Sep 1, 2020
Ownership / control type
Proprietary
Organization structure
GovernmentNon-profit
Enrollment address
8200 Brookriver Dr
Ste N500
Dallas, TX 75247-4037
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Ut Southwestern Home Health CareCCN 678078 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Oct 26, 1995
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
45D0908675Ut Southwestern Medical Center at Dallas8200 Brookriver Dr Suite N500, Dallas, TX 75247Certificate of waiverNov 9, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2710 N Stemmons Fwy
Ste 300
Dallas, TX 75207
Phone (214) 590-9600

6333 Forest Park Rd
Ste Blb
Dallas, TX 75235
Phone (214) 645-4570

8200 Brookriver Dr
Ste N500
Dallas, TX 75247
Phone (214) 648-9047

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Todd Prine Individual W-2 Managing EmployeeAsst. Director, Reimbursement Nov 7, 2018
Operational/Managerial Control Sep 13, 2021
Mark a Meyer Individual Corporate OfficerCfo Nov 13, 2017
W-2 Managing EmployeeCfo Nov 13, 2017
Cynthia Bowerstock-Thiel Individual W-2 Managing EmployeeDirector Jun 23, 2025
Operational/Managerial ControlDirector/Administrator Jun 23, 2025
The University of Texas Southwestern Medical Center at Dallas Organization, Dallas, TX Non-profit Operational/Managerial Control Jan 1, 2005 100%
Vivyenne M.L. Roche Individual Corporate Director Jan 31, 2005
Christine Conquest Individual W-2 Managing EmployeeAlternate Administrator Dec 30, 2025

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763942400000",
    "number": "1508921313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 36423",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752359662",
            "telephone_number": "214-645-4570",
            "fax_number": "214-645-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 FOREST PARK ROAD",
            "address_2": "SUITE BLB 304",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753909279",
            "telephone_number": "214-645-4570",
            "fax_number": "214-645-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A",
        "authorized_official_last_name": "ROAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT FOR BUSINE",
        "authorized_official_telephone_number": "214-645-4570",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009569",
            "primary": true
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TPI175252901",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.offceally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC/Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UT Southwestern Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.