NPIMap

Organization Active NPI

Pecan Bayou Healthcare LLC

Doing business as CMS-Kinder Hearts Home Health

  • Home Health Agency
  • Early, TX
National Provider Identifier
1679184733
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PECAN BAYOU HEALTHCARE LLC
Doing business as
CMS-Kinder Hearts Home Health
Practice address
1102 Early Blvd
Early, TX 76802-2261
Phone
(325) 646-4900
NPI assigned
Aug 12, 2020
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 369-7608

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1102 Early Blvd
Early, TX 76802-2261

Mailing address

1102 Early Blvd
Early, TX 76802-2261
Phone (325) 646-4900

Other names 1

  • CMS-Kinder Hearts Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106002101 TX Part A Provider - Home Health Agency 6709296437 Practice locations: Coleman, TX; Early, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679184733. Details of each certification follow.

Home health agency certification: CCN 677177

Legal name
PECAN BAYOU HEALTHCARE LLC
Doing business as
CMS-KINDER HEARTS HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 2, 1988
Last certification
Oct 10, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Aug 12, 2020 in NV
Enrollment address
1102 Early Blvd
Early, TX 76802-2261

Care Compare: Home health agency

Medicare Care Compare
Listed as
CMS-Kinder Hearts Home HealthCCN 677177 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Nov 2, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
45D0693751Pecan Bayou Healthcare, LLC1102 Early Blvd, Early, TX 76802Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

1102 Early Blvd
Early, TX 76802
Phone (325) 641-0210

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Tylene Hughes Individual W-2 Managing EmployeeAd;Executive Director May 28, 2026
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Direct Ownership Interest Sep 16, 2020 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Aug 5, 2021
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Sep 16, 2020 100%
John J Gochnour Individual Corporate OfficerPresident Mar 26, 2026
Amber Tueller Individual Corporate OfficerSecretary Mar 26, 2026
Elliot McMillan Individual Corporate OfficerVice President Mar 26, 2026

Facilities with the same owner 141

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

View all 141

Change-of-ownership history 1

DateEventCounterparty
Sep 16, 2020 Change of OwnershipThis provider was the buyer CMS Health Care, IncCCN 677177, TX, NPI 1336146323

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1679184733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 EARLY BLVD",
            "city": "EARLY",
            "state": "TX",
            "postal_code": "768022261",
            "telephone_number": "325-646-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 EARLY BLVD",
            "city": "EARLY",
            "state": "TX",
            "postal_code": "768022261",
            "telephone_number": "325-646-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN BAYOU HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-369-7608"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CMS-Kinder Hearts Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Early, TX

Sources for this page

Verify at the official NPI Registry.