Organization Active NPI

Concierge Home Care of Lake City LLC

Doing business as Concierge Home Care

  • Home Health Agency
  • Lake City, FL
National Provider Identifier
1639777345
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CONCIERGE HOME CARE OF LAKE CITY LLC
Doing business as
Concierge Home Care
Practice address
2929 W US Highway 90 Ste 106
Lake City, FL 32055-7283
Phone
(386) 626-0020
Fax
(352) 435-0303
NPI assigned
Oct 14, 2020
Last updated
Jul 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Mr. Robert Gregory Young
Title
Secretary & Cao
Phone
(904) 733-1003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2929 W US Highway 90 Ste 106
Lake City, FL 32055-7283

Mailing address

4655 Salisbury Rd Ste 110
Jacksonville, FL 32256-0957
Phone (904) 733-1003

Other identifiers 2

IdentifierTypeStateIssuer
299995200OtherFLAHCA
10D2220708OtherFLCLIA

Other names 1

  • Concierge Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210401002026 FL Part A Provider - Home Health Agency 5395152631 Practice locations: Lake City, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639777345. Details of each certification follow.

Home health agency certification: CCN 687144

Legal name
CONCIERGE HOME CARE OF LAKE CITY LLC
Doing business as
CONCIERGE HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 15, 2021
Last certification
Dec 15, 2021
Organization structure
LLCProprietary
Incorporated
Sep 11, 2020 in FL
Enrollment address
2929 W US Highway 90
Ste 106
Lake City, FL 32055-7283

Care Compare: Home health agency

Medicare Care Compare
Listed as
Concierge Home CareCCN 687144 · All quality measures
Overall star rating
4.5 of 5
Ownership
-
Certified
Dec 15, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2929 W US Highway 90
Ste 106
Lake City, FL 32055
Phone (352) 435-0101

301 NW Cole Ter
Ste 105
Lake City, FL 32055
Phone (352) 435-0101

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Homecare Partners Holdings, LLC Organization, Jacksonville, FL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 99.21%
Waud Capital Partners Fif IV, L.P. Organization, Chicago, IL Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 24, 2026 23.45%
Waud Homecare Partners Holdings, LLC Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 65.54%
Jeffrey L Fisher Individual Corporate OfficerPresident Sep 11, 2020
New York State Teachers' Retirement System Organization, Albany, NY Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 6.16%
Emily Musgrove Individual W-2 Managing EmployeeDirector of Nursing/Alt Admin Jul 30, 2025
Reeve B. Waud Declaration of Trust DTD 02/21/96 Organization, Chicago, IL 5% Or Greater Indirect Ownership Interest Apr 24, 2026 5.86%
Homecare Partners Management, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 11, 2020 100%
Homecare Partners Acquisition Co., LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 11, 2020 100%
Robert Young Individual Corporate OfficerSecretary and Chief Administrati Sep 11, 2020
Waud Capital Affiliates IV, LLC Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 12.14%
Homecare Partners Intermediate Holdings, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Sep 11, 2020 100%
WCP Fif IV (Homecare Partners), L.P. Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 23.69%
David Christopher Rucker Individual Corporate OfficerChief Executive Officer Sep 11, 2020
Joseph Malone Individual Operational/Managerial ControlCfo Jun 1, 2025
Waud Capital Partners QP IV, L.P. Organization, Chicago, IL Holding company 5% Or Greater Indirect Ownership Interest Sep 11, 2020 50.61%
WCP Fif IV Homecare Partners Blocker, Inc. Organization, Chicago, IL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Apr 24, 2026 23.45%
Katherine Mercer Individual W-2 Managing EmployeeAdmin Oct 12, 2023
Jacksonville Owners Holdings, Inc. Organization, Jacksonville, FL Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 11, 2020 6.72%
Concierge Home Care of Lake City Holdings, LLC Organization, Jacksonville, FL LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Sep 11, 2020 100%

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Affiliated clinicians 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1639777345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 SALISBURY RD STE 110",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560957",
            "telephone_number": "904-733-1003",
            "fax_number": "904-448-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 W US HIGHWAY 90 STE 106",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320557283",
            "telephone_number": "386-626-0020",
            "fax_number": "352-435-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE HOME CARE OF LAKE CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "SECRETARY & CAO",
        "authorized_official_telephone_number": "904-733-1003",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA",
            "identifier": "299995200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D2220708",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concierge Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Concierge Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.