NPIMap

Organization Active NPI

Iph Health Care Services, Inc.

Doing business as Iph Home Health

  • Home Health Agency
  • Lake Jackson, TX
National Provider Identifier
1679553069
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IPH HEALTH CARE SERVICES, INC.
Doing business as
Iph Home Health
IPH Home Health Care
Practice address
190 Abner Jackson Pkwy Ste 210
Lake Jackson, TX 77566-5170
Phone
(979) 529-2500
Fax
(979) 848-2028
NPI assigned
Jan 20, 2006
Last updated
Sep 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2022

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

Authorized official

Name
Mrs. Nancy Roman, CEO
Title
Ceo
Phone
(979) 529-2500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

190 Abner Jackson Pkwy Ste 210
Lake Jackson, TX 77566-5170

Mailing address

190 Abner Jackson Pkwy Ste 210
Lake Jackson, TX 77566-5170
Phone (979) 529-2500

Other identifiers 1

IdentifierTypeStateIssuer
0951303021MedicaidTX

Other names 2

  • IPH HOME HEALTH Doing business as
  • IPH Home Health Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20080428000247 TX Part A Provider - Home Health Agency 8123106499 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: McAllen, TX
O20090428000007 TX Part A Provider - Home Health Agency 7012065204 Practice locations: Lake Jackson, TX
O20161003001323 TX Part B Supplier - Independent Clinical Laboratory 7012065204 Practice locations: Lake Jackson, TX

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1679553069. Details of each certification follow.

Home health agency certification: CCN 458032

Legal name
IPH HOME HEALTH CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 24, 1994
Last certification
Jul 12, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 9, 1994 in TX
Enrollment address
1300 N 10TH St
Ste 210
McAllen, TX 78501-4392

Home health agency certification: CCN 458399

Legal name
IPH HEALTH CARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 18, 1995
Last certification
May 10, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Nov 12, 2008 in TX
Enrollment address
190 Abner Jackson Pkwy
Ste 210
Lake Jackson, TX 77566-5170

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Iph Home Health Care IncCCN 458032 · All quality measures
Overall star rating
1.5 of 5
Ownership
Proprietary
Certified
May 24, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Home health agency

Medicare Care Compare
Listed as
Iph Home Health CareCCN 458399 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
May 18, 1995
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
45D0900669Iph Home Health Care Services, Inc190 Abner Jackson Parkway Ste 210, Lake Jackson, TX 77566Certificate of waiverMay 2, 2027

National Provider Directory

National Provider Directory

Locations

190 Abner Jackson Pkwy
Ste 210
Lake Jackson, TX 77566
Phone (979) 529-2500

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Mirna Lugo Individual W-2 Managing Employee Oct 14, 2019
Jose Marin Individual 5% Or Greater Direct Ownership InterestPresident Oct 14, 2019 100%
Suzelle Martin Individual W-2 Managing Employee Aug 14, 2011
Lisa Ann Charbula Individual Corporate DirectorAdministrator Feb 20, 2015
W-2 Managing EmployeeAdministrator Feb 20, 2015 100%
Nancy Roman Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009
Corporate Director Jan 1, 2009
W-2 Managing Employee Jan 1, 2009
Reynaldo Roman Individual 5% Or Greater Direct Ownership Interest Jan 1, 2009
Corporate Director Jan 1, 2009
W-2 Managing Employee Jan 1, 2009

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1679553069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PKWY STE 210",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665170",
            "telephone_number": "979-529-2500",
            "fax_number": "979-848-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PKWY STE 210",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665170",
            "telephone_number": "979-529-2500",
            "fax_number": "979-848-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPH HEALTH CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-529-2500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0951303021",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IPH HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IPH Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IPH Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Jackson, TX

Sources for this page

Verify at the official NPI Registry.