NPIMap

Organization Active NPI

Icare Home Health & Hospice, LLC

  • Home Health Agency
  • Provo, UT
National Provider Identifier
1679879837
Registry record updated Oct 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
251E0000X Issued in UT
Legal business name
ICARE HOME HEALTH & HOSPICE, LLC
Practice address
1503 S 40 E
Suite 303
Provo, UT 84606-7300
Phone
(801) 228-0411
Fax
(801) 356-0204
NPI assigned
Feb 7, 2011
Last updated
Oct 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2011

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

Authorized official

Name
Mrs. Jill Erickson
Title
Administrator
Phone
(801) 427-4723

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 251E0000X UT Primary

Addresses

Primary practice location

1503 S 40 E
Suite 303
Provo, UT 84606-7300

Mailing address

1503 S 40 E
Suite 330
Provo, UT 84606-7300
Phone (801) 228-0411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110406000585 UT Part A Provider - Home Health Agency 3577746833 Practice locations: Springville, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679879837. Details of each certification follow.

Home health agency certification: CCN 467323

Legal name
ICARE HOME HEALTH & HOSPICE, LLC
Doing business as
ICARE HOME HEALTH & HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 21, 2011
Last certification
Jul 10, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 24, 2011 in UT
Enrollment address
672W 400 S 202
Springville, UT 84663-3170

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Icare Home HealthCCN 467323 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Sep 21, 2011
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Icare Home Health and Hospice2 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.

Locations

1503 S 40 E
Ste 303
Provo, UT 84606
Phone (801) 228-0411

Ownership & related parties

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.

NameRoleSinceShare
Emily a Hunsacker Individual 5% Or Greater Direct Ownership InterestOwner Dec 6, 2011 50%
W-2 Managing EmployeeOwner Dec 6, 2011 50%
Operational/Managerial ControlOwner Dec 6, 2011 50%
Jill Erickson Individual 5% Or Greater Direct Ownership InterestOwner Dec 6, 2011 50%
W-2 Managing EmployeeOwner Dec 6, 2011 50%
Operational/Managerial ControlOwner Dec 6, 2011 50%

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 7

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

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1679879837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 S 40 E",
            "address_2": "SUITE 330",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846067300",
            "telephone_number": "801-228-0411",
            "fax_number": "801-356-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S 40 E",
            "address_2": "SUITE 303",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846067300",
            "telephone_number": "801-228-0411",
            "fax_number": "801-356-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICARE HOME HEALTH & HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-427-4723",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "251E0000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.