NPIMap

Organization Active NPI

Careage Home Health LLC

  • Home Health Agency
  • Bellevue, WA
National Provider Identifier
1629288618
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
IHS.FS.60007888 Issued in WA
Legal business name
CAREAGE HOME HEALTH LLC
Practice address
14450 NE 29TH PL
Suite 106
Bellevue, WA 98007-8616
Phone
(425) 519-1265
Fax
(425) 861-7879
NPI assigned
May 22, 2007
Last updated
Feb 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Authorized official

Name
Mr. Kelly L Callahan
Title
Ceo
Phone
(253) 853-4457

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X IHS.FS.60007888 WA Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

14450 NE 29TH PL
Suite 106
Bellevue, WA 98007-8616

Mailing address

PO Box 1969
Gig Harbor, WA 98335-3969
Phone (253) 853-4457

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080122000262 WA Part A Provider - Home Health Agency 6709967383 Practice locations: Renton, WA; Bellevue, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629288618. Details of each certification follow.

Home health agency certification: CCN 507102

Legal name
CAREAGE HOME HEALTH LLC
Doing business as
CAREAGE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 22, 1994
Last certification
Jul 7, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2310 130TH Ave NE
Ste 101
Bellevue, WA 98005-1757

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Careage Home HealthCCN 507102 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Nov 22, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

14450 NE 29th Pl
Ste 106
Bellevue, WA 98007
Phone (425) 519-1265

2020 124th Ave NE
Ste C206
Bellevue, WA 98005
Phone (425) 519-1265

4924 109th St SW
Lakewood, WA 98499
Phone (253) 240-4601

234 SW 43rd St
Ste Md
Renton, WA 98057
Phone (425) 251-4306

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Scott H Buck Individual W-2 Managing EmployeeVP Business Intelligence and HH Dec 1, 2021 100%
Evelyn M Lynn Individual 5% Or Greater Indirect Ownership Interest Aug 23, 2018 100%
Careage Healthcare of Wa Organization, Gig Harbor, WA For-profit Operational/Managerial Control Sep 10, 2007 1%
Gene E. Lynn Living Trust Organization, Gig Harbor, WA 5% Or Greater Direct Ownership Interest Aug 23, 2018 100%
Teresa M Baril Individual Operational/Managerial ControlController May 2, 2019 5%
Melinda H Deitz Individual Operational/Managerial Control May 2, 2019 5%

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1629288618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1969",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983353969",
            "telephone_number": "253-853-4457",
            "fax_number": "253-853-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14450 NE 29TH PL",
            "address_2": "SUITE 106",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980078616",
            "telephone_number": "425-519-1265",
            "fax_number": "425-861-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREAGE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "CALLAHAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "253-853-4457",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "IHS.FS.60007888",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.