Evening Star Healthcare, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

009549 Issued in TX

Legal business name

EVENING STAR HEALTHCARE, INC.

Practice address

6111 Evening Sun CT
Richmond, TX 77469-9873

Phone

(281) 344-1411

Fax

(281) 344-1611

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Emmanuel Mbidoaka, B.SC, LVN

Title

Administrator

Phone

(281) 344-1411

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 677984

Legal name

EVENING STAR HEALTHCARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 30, 2006

Last certification

Aug 6, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Aug 24, 2004 in TX

Enrollment address

6111 Evening Sun CT
Richmond, TX 77469-9873

Listed as

Evening Star Healthcare IncCCN 677984

Ownership

Proprietary

Certified

Jun 30, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 3

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

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718236800000",
    "number": "1689628877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 EVENING SUN CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774699873",
            "telephone_number": "281-344-1411",
            "fax_number": "281-344-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 EVENING SUN CT",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774699873",
            "telephone_number": "281-344-1411",
            "fax_number": "281-344-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVENING STAR HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A",
        "authorized_official_last_name": "MBIDOAKA",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-344-1411",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "B.SC, LVN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCSSA LICENSE",
            "identifier": "009549",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohammad Etminan, M.D.
• Mercy Etukho
• Alan Thomas Evans, PA
• Camille Mayshea Evans
• Kenithia Evans, RN
• Ever Radiant Behavioral Health PLLC
• Evergreen Behavioral Health, LLC
• Evergreen Care & Residence
• Evergreen Homecare Services,LLC
• Everything Dental PLLC

• All providers in Richmond, TX
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.

Verify at the official NPI Registry.