NPIMap

Organization Active NPI

Innovative Senior Care Home Health of Tulsa LLC

  • Home Health Agency
  • Broken Arrow, OK
National Provider Identifier
1699074997
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
INNOVATIVE SENIOR CARE HOME HEALTH OF TULSA LLC
Doing business as
Assured Home Health
Practice address
1621 S Eucalyptus Ave Ste 102
Broken Arrow, OK 74012-5948
Phone
(918) 298-0275
Fax
(918) 298-4838
NPI assigned
Mar 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Executive Vice President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1621 S Eucalyptus Ave Ste 102
Broken Arrow, OK 74012-5948

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Assured Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110509000206 OK Part A Provider - Home Health Agency 2961688957 Practice locations: Broken Arrow, OK

Home health agency certification: CCN 377126

Legal name
INNOVATIVE SENIOR CARE HOME HEALTH OF TULSA LLC
Doing business as
ASSURED HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 18, 1985
Last certification
Dec 5, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
1621 S Eucalyptus Ave
Ste 102
Broken Arrow, OK 74012-5948

Care Compare: Home health agency

Medicare Care Compare
Listed as
Assured Home HealthCCN 377126 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 18, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, 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
37D1094143Assured Home Health1621 S Eucalyptus Ave, Suite 102, Broken Arrow, OK 74012Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1621 S Eucalyptus Ave
Ste 102
Broken Arrow, OK 74012
Phone (918) 298-0275

401 E Broadway St
#250
Sand Springs, OK 74063
Phone (918) 246-0404

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Sherry Downing Individual W-2 Managing EmployeeDirector of Nursing Nov 1, 2021
Operational/Managerial ControlDirector of Nursing Nov 1, 2021
Shawna Vernon Individual W-2 Managing EmployeeAd; Mar 26, 2025
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCfo/Treasurer Feb 22, 2023
Health at Home Holdings LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
Tennessee Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
Wendy S Daigle Individual Corporate Director Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Nov 1, 2021
Health at Home Holdings-Tulsa, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Nov 1, 2021 100%
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025

Facilities with the same owner 46

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

View all 46

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1301011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1699074997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 S EUCALYPTUS AVE STE 102",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740125948",
            "telephone_number": "918-298-0275",
            "fax_number": "918-298-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SENIOR CARE HOME HEALTH OF TULSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-25",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assured Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.