NPIMap

Organization Active NPI

LHCG Clvii, LLC

  • Home Health Agency
  • Longwood, FL
National Provider Identifier
1568082402
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG CLVII, LLC
Practice address
2170 W State Road 434 Ste 250
Longwood, FL 32779-5012
Phone
(407) 661-1963
Fax
(407) 875-0286
NPI assigned
Apr 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Authorized official

Name
Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2170 W State Road 434 Ste 250
Longwood, FL 32779-5012

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Mederi Caretenders Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401000442 FL Part A Provider - Home Health Agency 5991112302 Practice locations: Longwood, FL

Home health agency certification: CCN 108014

Legal name
LHCG CLVII LLC
Doing business as
MEDERI CARETENDERS
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 15, 2003
Last certification
Jul 18, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2170 W State Road 434
Ste 250
Longwood, FL 32779-5012

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mederi CaretendersCCN 108014
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Dec 15, 2003
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
10D1035954LHCG Clvii LLC Dba Mederi Caretenders2170 W State Road 434 Suite 250, Longwood, FL 32779Certificate of waiverJan 17, 2027

National Provider Directory

National Provider Directory

Locations

474 S Northlake Blvd
Ste 1020
Altamonte Springs, FL 32701
Phone (407) 661-1963

2170 W State Road 434
Ste 250
Longwood, FL 32779
Phone (407) 661-1963

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 60%
Jamie M. Marschall Individual W-2 Managing EmployeeAd; Apr 1, 2026
Marcus Donavon Macip Individual Corporate OfficerSecretary Mar 1, 2023
Kimberly Seymour Individual Corporate OfficerCoo Apr 13, 2026
W-2 Managing Employee Apr 13, 2026
Joni Babineaux Individual Corporate OfficerCfo Apr 13, 2026
Wendy S Daigle Individual Corporate DirectorDirector, Licensure&Regulatory Oct 1, 2022
LHC Health Care Group of Florida, LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Aug 1, 2020 60%
Healthnet Services Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Aug 1, 2020 40%
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Aug 1, 2020 60%
Joshua Lee Proffitt Individual Corporate OfficerPresident Aug 1, 2020
Central Florida Parternship LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Aug 1, 2020 100%
Amy Cormier Individual Corporate DirectorDirector of Managed Care May 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 8

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

  • Bayfront Hma Home Health LLC
    • Home Health Agency
    • St Petersburg, FL
    • NPI 1407816465

    Central Florida Parternship LLC, Healthnet Services Inc., LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG Cliii, LLC
    • Home Health Agency
    • Orlando, FL
    • NPI 1093348997

    Central Florida Parternship LLC, Healthnet Services Inc., LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG Cliv, LLC
    • Home Health Agency
    • Clermont, FL
    • NPI 1063045961

    Central Florida Parternship LLC, Healthnet Services Inc., LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG CLV, LLC
    • Home Health Agency
    • Leesburg, FL
    • NPI 1649804220

    Central Florida Parternship LLC, Healthnet Services Inc., LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG Clvi, LLC
    • Home Health Agency
    • Kissimmee, FL
    • NPI 1639703218

    Central Florida Parternship LLC, Healthnet Services Inc., LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG Lxxxii, LLC
    • Home Health Agency
    • Titusville, FL
    • NPI 1306292370

    LHC Health Care Group of Florida, LLC

    CMS ownership
  • LHCG Xix, LLC
    • Home Health Agency
    • Pensacola, FL
    • NPI 1124337894

    LHC Health Care Group of Florida, LLC

    CMS ownership
  • Munroe Regional Homecare, LLC
    • Home Health Agency
    • Ocala, FL
    • NPI 1316072887

    LHC Health Care Group of Florida, LLC

    CMS ownership

Change-of-ownership history 1

DateEventCounterparty
Aug 1, 2020 Change of OwnershipThis provider was the buyer Mederi CaretendersCCN 108014, FL, NPI 1396841292

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 69

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

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1568082402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2170 W STATE ROAD 434 STE 250",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327795012",
            "telephone_number": "407-661-1963",
            "fax_number": "407-875-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG CLVII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mederi Caretenders",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.