NPIMap

Organization Active NPI

Preston Memorial Homecare, LLC

Doing business as Preston Memorial HomeCare

  • Home Health Agency
  • Kingwood, WV
National Provider Identifier
1659600310
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRESTON MEMORIAL HOMECARE, LLC
Doing business as
Preston Memorial HomeCare
Practice address
419 Morgantown St
Kingwood, WV 26537-1095
Phone
(304) 329-3565
Fax
(304) 329-4709
NPI assigned
Dec 9, 2009
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Mr. Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

419 Morgantown St
Kingwood, WV 26537-1095

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

410 E Main St
Kingwood, WV 26537-1723
Phone (304) 329-3565

Other names 1

  • Preston Memorial HomeCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100218000758 WV Part A Provider - Home Health Agency 8628112331 Practice locations: Kingwood, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659600310. Details of each certification follow.

Home health agency certification: CCN 517037B

Legal name
PRESTON MEMORIAL HOMECARE, LLC
Doing business as
PRESTON MEMORIAL HOMECARE
Organization structure
LLCProprietary
Incorporated
Oct 27, 2009 in WV
Enrollment address
419 Morgantown St
Kingwood, WV 26537-1095

Care Compare: Home health agency

Medicare Care Compare
Listed as
Preston Memorial HomecareCCN 517037
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Oct 15, 1977
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2003274Preston Memorial Homecare419 Morgantown Street, Kingwood, WV 26537Certificate of waiverFeb 3, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Locations

419 Morgantown St
Kingwood, WV 26537
Phone (304) 329-3565

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCfo/Treasurer Feb 22, 2023
West Virginia Health Care Group, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Apr 1, 2012 100%
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Jan 1, 2010 100%
Operational/Managerial Control Jan 1, 2010
Christy Hulvey Individual W-2 Managing EmployeeAdministrator/Don Aug 20, 2025
Joshua Lee Proffitt Individual Corporate OfficerPresident Aug 1, 2012
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1260316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1659600310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 MORGANTOWN ST",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371095",
            "telephone_number": "304-329-3565",
            "fax_number": "304-329-4709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 E Main St",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "WV",
            "postal_code": "265371723",
            "country_code": "US",
            "telephone_number": "304-329-3565",
            "fax_number": "304-329-4709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTON MEMORIAL HOMECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-09",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preston Memorial HomeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Preston Memorial HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingwood, WV

Sources for this page

Verify at the official NPI Registry.