Active NPI
Salmon Valley Home Health LLC
- Home Health Agency
- Salmon, ID
National Provider Identifier
1619467149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- SALMON VALLEY HOME HEALTH LLC
- Practice address
- 404 Courthouse Dr
Salmon, ID 83467-3341 - Phone
- (208) 993-8050
- Fax
- (208) 993-8046
- NPI assigned
- May 10, 2018
- 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
- Cindy L Clark
- Title
- Owner/Administrator
- Phone
- (208) 993-3479
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
404 Courthouse Dr
Salmon, ID 83467-3341
Mailing address
404 Courthouse Dr
Salmon, ID 83467-3341
Phone (208) 993-8050
Other practice location 1
1142 Ruth Ann Dr
Blackfoot, ID 83221-3663
Phone (208) 993-8050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190405000212 | ID | Part A Provider - Home Health Agency | 1052655933 | Practice locations: Salmon, ID |
Home health agency certification: CCN 137141
- Legal name
- SALMON VALLEY HOME HEALTH LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 24, 2020
- Last certification
- Apr 24, 2020
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Apr 1, 2018 in ID
- Enrollment address
- 404 Courthouse Dr
Salmon, ID 83467-3341
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Salmon Valley Home Health LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 24, 2020
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide
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 |
|---|---|---|---|
| 13D2210248 | Salmon Valley Home Health LLC | Certificate of waiver | Jan 19, 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 |
|---|---|---|---|
| Cindy L Clark | 5% Or Greater Direct Ownership Interest | Aug 1, 2018 | 51% |
| Corporate Officer | Aug 1, 2018 | 100% | |
| Corporate Director | Aug 1, 2018 | 100% | |
| Operational/Managerial Control | Aug 1, 2018 | 100% | |
| William V Clark | 5% Or Greater Direct Ownership Interest | Aug 1, 2018 | 49% |
| Corporate Officer | Aug 1, 2018 | 25% |
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1755216000000",
"number": "1619467149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 COURTHOUSE DR",
"city": "SALMON",
"state": "ID",
"postal_code": "834673341",
"telephone_number": "208-993-8050",
"fax_number": "208-993-8046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 COURTHOUSE DR",
"city": "SALMON",
"state": "ID",
"postal_code": "834673341",
"telephone_number": "208-993-8050",
"fax_number": "208-993-8046"
}
],
"practiceLocations": [
{
"address_1": "1142 Ruth Ann Dr",
"address_purpose": "LOCATION",
"city": "Blackfoot",
"state": "ID",
"postal_code": "832213663",
"country_code": "US",
"telephone_number": "208-993-8050",
"fax_number": "208-993-8046",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SALMON VALLEY HOME HEALTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-05-10",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "CINDY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
"authorized_official_telephone_number": "208-993-3479"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salmon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.