Shining Star Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

009851 Issued in TX

Legal business name

SHINING STAR HOME HEALTH CARE INC

Practice address

713 Gatewood Rd Ste B
Garland, TX 75043-8528

Phone

(469) 366-9767

Fax

(469) 366-9875

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Susan Vattachackal

Title

Administrator

Phone

(469) 366-9767

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 677894

Legal name

SHINING STAR HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 4, 2006

Last certification

Aug 26, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 22, 2005 in TX

Enrollment address

713 Gatewood Rd
Ste B
Garland, TX 75043-8528

Listed as

Shining Star Home Health Care Inc.CCN 677894

Overall star rating

2 of 5

Ownership

Proprietary

Certified

Apr 4, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Affiliated clinicians 2

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

• Naureen Salim

  • Family Nurse Practitioner
  • Lewisville, TX
  • NPI 1881281905

  Home health agency

  Care Compare affiliation
• Paidamoyo Yvonne Wagoneka

  • Family Nurse Practitioner
  • Mansfield, TX
  • NPI 1700391257

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1629280110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 GATEWOOD RD STE B",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750438528",
            "telephone_number": "469-366-9767",
            "fax_number": "469-366-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 GATEWOOD RD STE B",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750438528",
            "telephone_number": "469-366-9767",
            "fax_number": "469-366-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINING STAR HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-03",
        "status": "A",
        "authorized_official_last_name": "VATTACHACKAL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-366-9767",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804817-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cynthia L Shinoda, LPC
• Shiva Shirvani, D.C.
• Shiwa Transportation LLC
• Shots on Site LLC
• Laketria Shoulders

• Home Health Agency in Garland, TX
• Providers in Garland, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.

Verify at the official NPI Registry.