Active NPI
Kingly Home Health Care Inc
- Home Health Agency
- Irving, TX
National Provider Identifier
1598858870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 009978
- Legal business name
- KINGLY HOME HEALTH CARE INC
- Practice address
- 1219 Stewart Dr
Irving, TX 75061-7354 - Phone
- (469) 586-4560
- Fax
- (468) 586-4561
- NPI assigned
- Oct 1, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Rachel Philip, RN
- Title
- Administrator
- Phone
- (469) 586-4560
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 009978 | TX | Primary |
Addresses
Primary practice location
1219 Stewart Dr
Irving, TX 75061-7354
Mailing address
1219 Stewart Dr
Irving, TX 75061-7354
Phone (469) 586-4560
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050819000100 | TX | Part A Provider - Home Health Agency | 9436189438 | Practice locations: Irving, TX |
Home health agency certification: CCN 677982
- Legal name
- KINGLY HOME HEALTH CARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 5, 2006
- Last certification
- May 15, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- May 26, 2005 in TX
- Enrollment address
- 1219 Stewart Drive
Irving, TX 75061-7354
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Kingly Home Health Care, Incorporated.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jul 5, 2006
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1043967 | Kingly Home Health Care Incorporated | Certificate of waiver | Aug 7, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Chamathil Philip | 5% Or Greater Direct Ownership Interest | May 26, 2005 | |
| Corporate Officer | May 26, 2005 | ||
| Corporate Director | Aug 19, 2005 | ||
| W-2 Managing Employee | May 26, 2005 | ||
| Rachel Philip | 5% Or Greater Direct Ownership Interest | May 26, 2005 | |
| Corporate Director | Aug 19, 2005 | ||
| W-2 Managing Employee | May 26, 2005 |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Lewisville, TX
- NPI 1023547692
Home health agency
-
- Cardiovascular Disease Physician
- Irving, TX
- NPI 1689673576
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159660800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1470096000000",
"number": "1598858870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1219 STEWART DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750617354",
"telephone_number": "469-586-4560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 STEWART DR",
"city": "IRVING",
"state": "TX",
"postal_code": "750617354",
"telephone_number": "469-586-4560",
"fax_number": "468-586-4561"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KINGLY HOME HEALTH CARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-01",
"last_updated": "2016-08-02",
"status": "A",
"authorized_official_last_name": "PHILIP",
"authorized_official_first_name": "RACHEL",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "469-586-4560",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "009978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.