Primary Home Health Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

04G501 Issued in CO

Legal business name

PRIMARY HOME HEALTH CARE, INC.

Practice address

111 E. Polk Street
Colorado Springs, CO 80907-6227

Phone

(719) 577-4272

Fax

(719) 227-9272

NPI assigned

Feb 21, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Diana Louise Prime, R.N.

Title

Vice-President

Phone

(719) 577-4272

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Home health agency certification: CCN 067476

Legal name

PRIMARY HOME HEALTH CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 13, 2008

Last certification

Dec 9, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 21, 2008 in CO

Enrollment address

111 E Polk St
Colorado Springs, CO 80907-6267

Listed as

Primary Home Health Care IncCCN 067476

Ownership

Proprietary

Certified

Dec 13, 2008

Medicare certification status

ActiveFrom the Provider of Services file

Services

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

Tax ID family

Primary Home Health Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primary Home Health Care, Inc.

  • In Home Supportive Care Agency
  • Colorado Springs, CO
  • NPI 1376991893
  NPD tax ID

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.

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1659540862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E. POLK STREET",
            "address_2": "111 E. POLK STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809096227",
            "telephone_number": "719-577-4272",
            "fax_number": "719-227-9272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E. POLK STREET",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809076227",
            "telephone_number": "719-577-4272",
            "fax_number": "719-227-9272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "PRIME",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "719-577-4272",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CO",
            "license": "04G501",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CO",
            "license": "04K988",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": "CO",
            "license": "040244",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37422791",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41652576",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Christopher Prickett
• Kelsey Priddy, PA
• Brad Joseph Priebe, DO
• Primary Care Physicians, P.C.
• Primary Home Health Care, Inc.
• Prime Fitness, LLC
• Primepath Medical LLC
• Primrose Medical Supply, LLC
• Marissa Irene Prince, PHD
• Stanley Prince

• Home Health Agency in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Home Health Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.