Active NPI
Village Home Care of the Palm Beaches, LLC
- Home Health Agency
- Boynton Beach, FL
National Provider Identifier
1689619298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- VILLAGE HOME CARE OF THE PALM BEACHES, LLC
- Practice address
- 1500 Gateway Blvd Ste 220
Boynton Beach, FL 33426-7233 - Phone
- (561) 499-1335
- Fax
- (888) 301-3144
- NPI assigned
- Jun 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joy L Rodak
- Title
- Ceo
- Phone
- (561) 499-1335
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1500 Gateway Blvd Ste 220
Boynton Beach, FL 33426-7233
Mailing address
1269 E Silver Springs Blvd
Ocala, FL 34470-6805
Phone (352) 873-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060721000076 | FL | Part A Provider - Home Health Agency | 3274546072 | Practice locations: Boynton Beach, FL |
Home health agency certification: CCN 108378
- Legal name
- VILLAGE HOME CARE OF THE PALM BEACHES, LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 27, 2006
- Last certification
- Jun 15, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Incorporated
- May 13, 2005 in FL
- Enrollment address
- 1500 Gateway Blvd
Ste 220
Boynton Beach, FL 33426-7233
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Village Home Care of the Palm Beaches LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Dec 27, 2006
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Occupational therapy
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Home Health Agency
- Newburyport, MA
- NPI 1083007439
Member Of
Locations
4733 W Atlantic Ave
Ste C16
Delray Beach, FL 33445
Phone (561) 455-2162
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
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.
| Name | Role | Since | Share |
|---|---|---|---|
| James J Devoursney | 5% Or Greater Direct Ownership Interest | Jun 16, 2006 | 16% |
| Limited Partnership Interest | Jun 16, 2006 | 14% | |
| Rachael Fitzpatrick | 5% Or Greater Indirect Ownership Interest | Jun 12, 2009 | 12.5% |
| Carol Hollins | W-2 Managing Employee | Jun 16, 2006 | |
| Joy Rodak | Contracted Managing Employee | Feb 1, 2006 | 50% |
| 5% Or Greater Direct Ownership Interest | Jun 16, 2006 | 30% | |
| Limited Partnership Interest | Jun 16, 2006 | 30% | |
| Corporate Officer | Jun 16, 2006 | 50% | |
| Corporate Director | Jun 16, 2006 | 50% | |
| Operational/Managerial Control | Feb 1, 2006 | 30% | |
| TKR, Inc | 5% Or Greater Direct Ownership Interest | May 1, 2015 | 30% |
| Tami Shemanske | 5% Or Greater Indirect Ownership Interest | Apr 26, 2010 | 3% |
| Kim Metcalf-Richards | 5% Or Greater Indirect Ownership Interest | Jun 12, 2009 | 12.5% |
| William Shemanske | 5% Or Greater Indirect Ownership Interest | Apr 26, 2010 | 2% |
| Fbjpgm | 5% Or Greater Direct Ownership Interest | Jun 16, 2006 | 20% |
| Limited Partnership Interest | Jun 16, 2006 | 20% |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Dermatology Physician
- Boynton Beach, FL
- NPI 1871696021
5% Or Greater Direct Ownership Interest, Limited Partnership Interest
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Maitland, FL
- NPI 1366103236
-
- Dermatology Physician
- Boynton Beach, FL
- NPI 1871696021
Affiliated clinicians 1
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": "1150588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738540800000",
"number": "1689619298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1269 E SILVER SPRINGS BLVD",
"city": "OCALA",
"state": "FL",
"postal_code": "344706805",
"telephone_number": "352-873-8300",
"fax_number": "352-368-9887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 GATEWAY BLVD STE 220",
"city": "BOYNTON BEACH",
"state": "FL",
"postal_code": "334267233",
"telephone_number": "561-499-1335",
"fax_number": "888-301-3144"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLAGE HOME CARE OF THE PALM BEACHES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-18",
"last_updated": "2025-02-03",
"certification_date": "2025-02-03",
"status": "A",
"authorized_official_last_name": "RODAK",
"authorized_official_first_name": "JOY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "561-499-1335"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boynton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.