LHCG Cxii, LLC
Organization Active NPI Home Health Agency · Tyler, TX
NPI 1669994471 · NPPES record last updated Jan 22, 2024
Key facts
- NPI
- 1669994471
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- LHCG CXII, LLC
- Practice address
- 821 E Southeast Loop 323 Ste 360
Tyler, TX 75701-9667 - Phone
- (903) 534-6267
- Fax
- (903) 534-6296
- NPI assigned
- Jul 13, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Joshua L Proffitt
- Title
- President
- Phone
- (337) 233-1307
Change of ownership 1
Facilities with the same owner 17
Affiliated clinicians 86
-
Joshua T Barker, MD
-
David H Beaird, MD
-
Russell Bell, DO
-
Matthew Boehme, D.O.
-
C. Renee Branch, D.O.
-
Sheryl Ann Busch, M.D.
-
Thomas M Buzbee Jr., M.D.
-
Angela N Cade, MD
-
Hayley Cantway, MD
-
Amber N Cook, MD
-
Audrey Crews, APRN, FNP-C
-
Jimmy W Dailey, MD
-
Anthony Dewayne Davis, M.D.
-
Amy Michelle Dean, MSN-FNP
-
Lori Marie Duke, APRN, FNP-C
-
Alan M Eli, MD
Medicare Care Compare: Home health agency
- Listed as
- Christus Homecare
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Proprietary
- Certified
- Sep 29, 2008
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D1068345 | LHCG Cxii, LLC | Certificate of waiver | May 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Home health agency certification: CCN 743197
- Legal name
- LHCG CXII, LLC
- Doing business as
- CHRISTUS HOMECARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 29, 2008
- Last certification
- Jun 8, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Enrollment address
- 821 E Southeast Loop 323
Ste 360
Tyler, TX 75701-9667
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Unitedhealth Group Incorporated |
5% Or Greater Indirect Ownership Interest | Feb 22, 2023 | 67% |
| Marcus Donavon Macip |
Corporate Officer |
Mar 1, 2023 | |
| Kimberly Seymour |
Corporate Officer |
Apr 13, 2026 | |
| W-2 Managing Employee |
Apr 13, 2026 | ||
| Joni Babineaux |
Corporate Officer |
Apr 13, 2026 | |
| Trisha Woolard |
W-2 Managing Employee |
May 21, 2018 | |
| Operational/Managerial Control |
May 21, 2018 | ||
| Wendy S Daigle |
Corporate Director |
Oct 1, 2022 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | 67% |
| Operational/Managerial Control | Sep 1, 2017 | ||
| Southwest Post-Acute Care Partnership LLC |
5% Or Greater Direct Ownership Interest | Sep 1, 2017 | 100% |
| Joshua Lee Proffitt |
Corporate Officer |
Sep 1, 2017 | |
| LHCG Partner II LLC |
5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | 67% |
| Amy Cormier |
Corporate Director |
May 1, 2025 | |
| Christus Continuing Care |
5% Or Greater Indirect Ownership Interest | Sep 1, 2017 | 33% |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Sep 1, 2017 | Change of Ownership |
Christus Homecare |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171030000895 | TX | Part a Provider - Home Health Agency | 4486920899 | Practice locations: Tyler, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes | ||
| Nursing Care Agency | 251J00000X |
Addresses
Primary practice location
821 E Southeast Loop 323 Ste 360
Tyler, TX 75701-9667
Mailing address
PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307
Other names
- CHRISTUS Homecare
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 22, 2024. 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.