Arkansas Homecare of Forrest City, LLC
Organization Active NPI Home Health Agency · Forrest City, AR
NPI 1609821982 · NPPES record last updated Dec 27, 2023
Key facts
- NPI
- 1609821982
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- AR4442 (AR)
- Legal business name
- ARKANSAS HOMECARE OF FORREST CITY, LLC
- Practice address
- 4200 N Washington St Ste 1
Forrest City, AR 72335-7672 - Phone
- (870) 261-0188
- Fax
- (870) 261-0177
- NPI assigned
- May 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Joshua L Proffitt
- Title
- President
- Phone
- (337) 233-1307
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Facilities with the same owner 22
Affiliated clinicians 28
-
L.J. Patrick Bell II, D.O.
-
Maggie Bethell, APRN-CNP
-
Mark Standridge Bradshaw, M.D.
-
Willard Gene Burks, M.D.
-
James Donald Cathey, M.D.
-
Ashley Duncan, APRN
-
Scott Alan Hall, M.D.
-
Nancy Hornsby, APN
-
Rachel Ann Kalb, APRN
-
Sean Koch, MD
-
Sudhir Kumar, M.D.
-
Courtney B Manatt, APN
-
Monica Shea Martin, APRN
-
Sherry McCrary, APRN
-
Deanna Michaelis, FNP
-
Jason S Paxton, MD
-
Edward L Pillow, MD
-
James Hargraves Pillow, M.D.
-
Dana R. Reed, APN
-
Jodi Renigar, APRN, FNP-BC
Medicare Care Compare: Home health agency
- Listed as
- Elite Home Health
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Jul 1, 1991
- Medicare certification status
- Active
- Services
- Nursing, Physical therapy, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D1061739 | Elite Home Health | Certificate of waiver | Nov 27, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Home health agency certification: CCN 047128
- Legal name
- ARKANSAS HOMECARE OF FORREST CITY, LLC
- Doing business as
- ELITE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jul 1, 1991
- Last certification
- Aug 21, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Apr 24, 2006 in AR
- Enrollment address
- 4200 N Washington Street
Suite 1
Forrest City, AR 72335-7672
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Arkansas Health Care Group LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2006 | 100% |
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 100% |
| Marcus Donavon Macip |
Corporate Officer |
Feb 22, 2023 | |
| Jessica R Armstrong |
W-2 Managing Employee |
Dec 4, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Feb 22, 2023 | |
| Wendy S Daigle |
Other |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Jun 1, 2006 | 100% |
| Joshua Lee Proffitt |
Corporate Officer |
Aug 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060809000282 | AR | Part a Provider - Home Health Agency | 7517960784 | Practice locations: Forrest City, AR |
National Provider Directory
- Tax ID family
- Acmc Family Home Health
Locations
300 Eldridge Rd
Ste 7
Forrest City, AR 72335
Phone (870) 261-0188
3105 N Washington St
#7
Forrest City, AR 72335
Phone (870) 261-0188
4200 N Washington St
#1
Forrest City, AR 72335
Phone (870) 261-0188
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | AR4442 | AR | Yes |
Addresses
Primary practice location
4200 N Washington St Ste 1
Forrest City, AR 72335-7672
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other practice location 1
300 Eldridge Rd Ste 7
Forrest City, AR 72335-9516
Phone (870) 261-0188
Other practice location 2
3105 N Washington St
Suite 7
Forrest City, AR 72335-9578
Phone (870) 261-0188
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162947514 | Medicaid | AR | |
| 17128 | Other | AR | ARKANSAS BLUE CROSS BLUE |
Other names
- Elite Home Health
Other providers in Forrest City, AR
- Stephanie Chapman Apple
- Brandon Darnell Applewhite
- Arcare
- Taylor Arens
- Arkansas Department of Health
- Kaneisha Austin
- Paul Bailey III
- Sudesh Banaji
- Brandi Nicole Banks
- Likeselam Bantu
All providers in Forrest City, AR · Home Health Agency in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.