NPIMap

Organization Active NPI

Southwestern Home Health Care, Inc.

  • Home Health Agency
  • Farmington, NM
National Provider Identifier
1699820068
Registry record updated Apr 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
6547 Issued in NM
Legal business name
SOUTHWESTERN HOME HEALTH CARE, INC.
Practice address
408 N Auburn Ave Ste B
Farmington, NM 87401-5816
Phone
(505) 326-6024
Fax
(505) 327-6923
NPI assigned
Jan 24, 2007
Last updated
Apr 12, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2019

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

Authorized official

Name
Ivy Snider, RN
Title
President
Phone
(405) 216-3785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 6547 NM Primary

Addresses

Primary practice location

408 N Auburn Ave Ste B
Farmington, NM 87401-5816

Mailing address

2232 NW 164TH St
Edmond, OK 73013-8801
Phone (405) 216-3785

Other identifiers 1

IdentifierTypeStateIssuer
N2742MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120502000267 NM Part A Provider - Home Health Agency 9133250558 Practice locations: Farmington, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699820068. Details of each certification follow.

Home health agency certification: CCN 327145

Legal name
SOUTHWESTERN HOME HEALTH CARE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 9, 1996
Last certification
Mar 26, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Enrollment address
408N Auburn Ave
Farmington, NM 87401-5816
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Southwestern Home Health Care, Inc.CCN 327145 · All quality measures
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Apr 9, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical 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
32D0913467Southwestern Home Health Care Inc408 N Auburn Ave, Farmington, NM 87401Certificate of waiverApr 1, 2028

National Provider Directory

National Provider Directory
Tax ID family
Southwestern Home Health Care2 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

408 N Auburn Ave
Farmington, NM 87401
Phone (505) 326-6024

2232 NW 164th St
Edmond, OK 73013

2600 N Wheeler Ave
Sallisaw, OK 74955
Phone (918) 775-7975

Ownership & related parties

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.

NameRoleSinceShare
Ivy Snider Individual 5% Or Greater Direct Ownership Interest Feb 25, 1996 51%
Corporate Officer Feb 25, 1996
W-2 Managing Employee Feb 25, 1996
Stephen Snider Individual 5% Or Greater Direct Ownership Interest Feb 25, 1996 45%
Corporate Officer Feb 25, 1996
W-2 Managing Employee Feb 25, 1996
Teryl Parker Individual W-2 Managing Employee Mar 24, 2003

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555027200000",
    "number": "1699820068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 NW 164TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138801",
            "telephone_number": "405-216-3785",
            "fax_number": "405-216-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 N AUBURN AVE STE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015816",
            "telephone_number": "505-326-6024",
            "fax_number": "505-327-6923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN HOME HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2019-04-12",
        "status": "A",
        "authorized_official_last_name": "SNIDER",
        "authorized_official_first_name": "IVY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-216-3785",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "6547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N2742",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.