Active NPI
Eden Home Health of Idaho Falls, LLC
Doing business as Eden Home Health
- Home Health Agency
- Idaho Falls, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HH-248
- Legal business name
- EDEN HOME HEALTH OF IDAHO FALLS, LLC
- Doing business as
- Eden Home Health
- Practice address
- 2540 Channing Way
Idaho Falls, ID 83404-7515 - Phone
- (208) 523-1980
- Fax
- (208) 523-4024
- NPI assigned
- Jun 9, 2014
- Last updated
- Feb 10, 2022
- Organization subpart
- Yes
- Parent organization
- EMPRES HOME HEALTH, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael J. Miller
- Title
- Cfo and Assistant Manager
- Phone
- (360) 892-6628
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HH-248 | ID | Primary |
| Nursing Care Agency | 251J00000X | |||
| Social Worker | 104100000X | |||
| Home Health Aide | 374U00000X | |||
| Physical Therapist | 225100000X | |||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
2540 Channing Way
Idaho Falls, ID 83404-7515
Mailing address
4601 NE 77TH Ave
Suite 300
Vancouver, WA 98662-6729
Phone (360) 892-6628
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649683582 | Other | ID | NPI |
| 1649683582 | Medicaid | ID | |
| HH-248 | Other | ID | STATE HOME HEALTH LICENSE |
Other names 1
- Eden Home Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140707000315 | ID | Part A Provider - Home Health Agency | 1951526094 | Practice locations: Idaho Falls, ID |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1649683582. Details of each certification follow.
Home health agency certification: CCN 137119
- Legal name
- EDEN HOME HEALTH OF IDAHO FALLS, LLC
- Doing business as
- EDEN HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Apr 15, 2011
- Last certification
- Nov 19, 2014
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- Oct 22, 2013 in WA
- Enrollment address
- 2540 Channing Way
Idaho Falls, ID 83404-7515
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Eden Home Health -Idahofalls
- Overall star rating
- Ownership
- Proprietary
- Certified
- Apr 15, 2011
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
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 |
|---|---|---|---|
| 13D2019972 | Eden Home Health | Certificate of waiver | Feb 9, 2027 |
National Provider Directory
National Provider DirectoryLocations
1480 Midway Ave
#7
Ammon, ID 83406
Phone (208) 523-1980
4601 NE 77th Ave
Ste 300
Vancouver, WA 98662
Ownership & related parties
All disclosed owners & managing parties 13
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 |
|---|---|---|---|
| Empres Home Health LLC | 5% Or Greater Direct Ownership Interest | Apr 13, 2023 | 100% |
| Empres Healthcare Group Inc | 5% Or Greater Indirect Ownership Interest | Apr 16, 2014 | 100% |
| Jacob R Bryan | W-2 Managing Employee | Apr 17, 2023 | 100% |
| Empres Home and Hospice LLC | 5% Or Greater Indirect Ownership Interest | Apr 13, 2023 | 100% |
| Jamie Brown | W-2 Managing Employee | May 4, 2007 | |
| Greatbanc Trust Company | Other | Apr 13, 2023 | 100% |
| Midcap Financial Trust | 5% Or Greater Security Interest | Feb 8, 2016 | 100% |
| Empres Financial Services LLC | Operational/Managerial Control | Apr 16, 2014 | |
| Debra Abbott | W-2 Managing Employee | Apr 13, 2023 | 100% |
| Michael J Miller | Corporate Officer | Apr 16, 2014 | |
| Eden Healthcare Management, LLC | Operational/Managerial Control | Jan 1, 2023 | 100% |
| Paul Johnson | W-2 Managing Employee | Jan 26, 2023 | 100% |
| Empres Healthcare Group, Inc. Employee Stock Ownership Trust | 5% Or Greater Indirect Ownership Interest | Apr 16, 2014 | 100% |
Facilities with the same owner 20
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Eden Home Health
- Home Health Agency
- Ponderay, ID
- NPI 1346898830
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Hospice
- Community Based Hospice Care Agency
- Idaho Falls, ID
- NPI 1669839395
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC
-
dba Eden Hospice
- Community Based Hospice Care Agency
- Ponderay, ID
- NPI 1245962471
Eden Healthcare Management, LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC
-
dba Eden Home Health
- Home Health Agency
- Bozeman, MT
- NPI 1659963999
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Home Health
- Home Health Agency
- Cheyenne, WY
- NPI 1497428338
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Home Health
- Home Health Agency
- Vancouver, WA
- NPI 1538778295
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Home Health
- Home Health Agency
- Tukwila, WA
- NPI 1003356403
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Home Health
- Home Health Agency
- Sierra Vista, AZ
- NPI 1568936334
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Home Health
- Home Health Agency
- Spokane Valley, WA
- NPI 1588212641
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC, Empres Home Health LLC
-
dba Eden Hospice
- Community Based Hospice Care Agency
- Reno, NV
- NPI 1487051728
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC
-
dba Eden Hospice
- Home Health Agency
- Cheyenne, WY
- NPI 1285307124
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC
-
dba Eden Hospice
- Community Based Hospice Care Agency
- Tukwila, WA
- NPI 1255922720
Eden Healthcare Management, LLC, Empres Financial Services LLC, Empres Healthcare Group Inc, Empres Healthcare Group, Inc. Employee Stock Ownership Trust, Empres Home and Hospice LLC
Practitioners & affiliated clinicians
Affiliated clinicians 22
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Neurological Surgery Physician
- Idaho Falls, ID
- NPI 1295942142
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402272000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644451200000",
"number": "1649683582",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 NE 77TH AVE",
"address_2": "SUITE 300",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986626729",
"telephone_number": "360-892-6628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2540 CHANNING WAY",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047515",
"telephone_number": "208-523-1980",
"fax_number": "208-523-4024"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EDEN HOME HEALTH OF IDAHO FALLS, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EMPRES HOME HEALTH, LLC",
"enumeration_date": "2014-06-09",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A",
"authorized_official_last_name": "MILLER",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "J.",
"authorized_official_title_or_position": "CFO AND ASSISTANT MANAGER",
"authorized_official_telephone_number": "360-892-6628"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "ID",
"license": "HH-248",
"primary": true
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1649683582",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1649683582",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE HOME HEALTH LICENSE",
"identifier": "HH-248",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Eden Home Health",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Eden Home Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.