CHC of Gainesville, LLC
Organization Active NPI Home Health Agency · Gainesville, FL
NPI 1629670310 · NPPES record last updated Dec 27, 2023
Key facts
- NPI
- 1629670310
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- CHC OF GAINESVILLE, LLC
- Practice address
- 4140 NW 37TH PL Ste B
Gainesville, FL 32606-8153 - Phone
- (352) 435-0101
- Fax
- (352) 435-0303
- NPI assigned
- Nov 9, 2020
- Organization subpart
- No
Authorized official
- Name
- Mr. Robert Gregory Young
- Title
- Secretary
- Phone
- (904) 733-1003
Member of 1
Facilities with the same owner 22
Affiliated clinicians 73
-
Angeli Maun Akey, MD
-
Neeka Akhavan, M.D.
-
Tristan Andrew Altbuch, M.D.
-
Robert Grady Ashley Jr., M.D.
-
Bernard H Ballou, MD
-
Hailee Banks, M.D.
-
Jennifer Leigh Banner, ARNP
-
Teresa Freeland Barr, ARNP
-
Catherine Mary Blackband, M.D.
-
Ingrid Allison Bozeman, DNP, APRN, PMHNP-BC
-
John J Burton, MD
-
Eyrone Morgan Bush, MSN, APRN, FNP-BC
-
Walter I Choung, MD
-
Jo-Anne Gammon, ARNP
-
Kimberly A Gonzalez, FNP
-
Julie R Graham, ARNP
-
Megan Elizabeth Green, APRN
Medicare Care Compare: Home health agency
- Listed as
- Concierge Home Care
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- -
- Certified
- Aug 20, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2219726 | CHC of Gainesville LLC | Certificate of waiver | Apr 6, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Home health agency certification: CCN 687196
- Legal name
- CHC OF GAINESVILLE, LLC
- Doing business as
- CONCIERGE HOME CARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 20, 2022
- Last certification
- Jun 22, 2022
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 17, 2020 in FL
- Enrollment address
- 4140 NW 37TH PL
Ste B
Gainesville, FL 32606-8153
All disclosed owners & managing parties 21
| Name | Role | Since | Share |
|---|---|---|---|
| Homecare Partners Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 99.21% |
| Waud Capital Partners Fif IV, L.P. |
5% Or Greater Indirect Ownership Interest | Apr 24, 2026 | 23.45% |
| Waud Homecare Partners Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 65.54% |
| Jeffrey L Fisher |
Corporate Officer |
Aug 17, 2020 | |
| Reeve B. Waud Declaration of Trust DTD 02/21/96 |
5% Or Greater Indirect Ownership Interest | Apr 24, 2026 | 5.86% |
| Kelly Mullins |
W-2 Managing Employee |
Feb 6, 2026 | |
| Lauzya M Van Rensburg |
W-2 Managing Employee |
Jan 8, 2022 | |
| Concierge Home Care of Gainesville Holdings, LLC |
5% Or Greater Direct Ownership Interest | Aug 17, 2020 | 100% |
| New York State Teachers' Retirement System |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 6.16% |
| Homecare Partners Management, LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 100% |
| Homecare Partners Acquisition Co., LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 100% |
| Robert Young |
Corporate Officer |
Aug 17, 2020 | |
| Operational/Managerial Control |
Oct 9, 2021 | ||
| Waud Capital Affiliates IV, LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 12.14% |
| Homecare Partners Intermediate Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 100% |
| WCP Fif IV (Homecare Partners), L.P. |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 23.69% |
| David Christopher Rucker |
Corporate Officer |
Aug 17, 2020 | |
| Joseph Malone |
W-2 Managing Employee |
Jun 1, 2025 | |
| Waud Capital Partners QP IV, L.P. |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 50.61% |
| WCP Fif IV Homecare Partners Blocker, Inc. |
5% Or Greater Indirect Ownership Interest | Apr 24, 2026 | 23.45% |
| Jacksonville Owners Holdings, Inc. |
5% Or Greater Indirect Ownership Interest | Aug 17, 2020 | 6.72% |
| Crescent Agency Services, LLC |
5% Or Greater Security Interest | May 25, 2021 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210401002399 | FL | Part a Provider - Home Health Agency | 2860809118 | Practice locations: Gainesville, FL |
National Provider Directory
Locations
4140 NW 37th Pl
Ste B
Gainesville, FL 32606
Phone (352) 435-0101
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
4140 NW 37TH PL Ste B
Gainesville, FL 32606-8153
Mailing address
4655 Salisbury Rd Ste 110
Jacksonville, FL 32256-0957
Phone (904) 733-1003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10D2219726 | Other | FL | CLIA |
| 299995198 | Other | FL | AHCA |
Other names
- Concierge Home Care
Other providers in Gainesville, FL
- Chase Hsing Chavez
- Elena Chavez
- Ma Luz Prias Chavez
- Ricardo Chavez
- Elyse Marie Chaviano
- Mabel Mambo Che-Tuma
- Fru Che
- Tram Thi Thu Che
- Victoria Larranaga Cheatwood
- Mohamad Chehab
All providers in Gainesville, FL · Home Health Agency in Florida
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.