NPIMap

Organization Active NPI

FV at Home - Home Health, LLC

Doing business as Friendship Village Home Health

  • Home Health Agency
  • Chesterfield, MO
National Provider Identifier
1700347275
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
FV AT HOME - HOME HEALTH, LLC
Doing business as
Friendship Village Home Health
Practice address
15201 Olive Blvd
Chesterfield, MO 63017-1810
Phone
(636) 733-0355
NPI assigned
Mar 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Sue Champion
Title
Administrative Services Director
Phone
(314) 270-7810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

15201 Olive Blvd
Chesterfield, MO 63017-1810

Mailing address

15201 Olive Blvd
Chesterfield, MO 63017-1810
Phone (636) 733-0355

Other names 1

  • Friendship Village Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190617000127 MO Part A Provider - Home Health Agency 9335472802 Practice locations: Chesterfield, MO; Saint Louis, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700347275. Details of each certification follow.

Home health agency certification: CCN 267599

Legal name
FV AT HOME - HOME HEALTH, LLC
Doing business as
FV AT HOME BY FRIENDSHIP VILLAGE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 5, 2005
Last certification
Dec 18, 2019
Ownership / control type
Non-Profit
Organization structure
LLCProprietary
Incorporated
Mar 6, 2018 in MO
Enrollment address
15201 Olive Blvd
Apt 257
Chesterfield, MO 63017-1813

Care Compare: Home health agency

Medicare Care Compare
Listed as
FV at Home by Friendship VillageCCN 267599 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Oct 5, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy, Speech pathology, 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
26D1101100FV at Home - Home Health LLC15201 Olive Blvd, Ste #345, Chesterfield, MO 63017Certificate of waiverJun 18, 2027

National Provider Directory

National Provider Directory

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.

NameRoleSinceShare
Carmen Fronczak Individual Corporate OfficerVice-President Jul 1, 2021
Christina Hood Individual Corporate OfficerTreasurer Jan 29, 2026
Friendship Village at Home, LLC Organization, Saint Louis, MO LLC, Non-profit 5% Or Greater Direct Ownership Interest Apr 6, 2019 100%
FV Services, Inc Organization, Saint Louis, MO Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 6, 2019 100%
David a Giffin Individual Corporate DirectorManager Apr 6, 2019
Lydia Lynne Seibert Individual Corporate DirectorManager Jul 1, 2021
Stacey Zerban Individual W-2 Managing EmployeeAd; Jan 1, 2026
James T Walsh Individual Corporate OfficerPresident Apr 6, 2019
Corporate DirectorManager Apr 6, 2019
Gayle a Randa Individual Corporate OfficerCompliance Off, Privacy & Sec. Off Apr 6, 2019

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

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

Change-of-ownership history 1

DateEventCounterparty
Apr 6, 2019 Change of OwnershipThis provider was the buyer Health at HomeCCN 267599, MO, NPI 1306158217

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1700347275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15201 OLIVE BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171810",
            "telephone_number": "636-733-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15201 OLIVE BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630171810",
            "telephone_number": "636-733-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FV AT HOME - HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2023-10-11",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "CHAMPION",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATIVE SERVICES DIRECTOR",
        "authorized_official_telephone_number": "314-270-7810"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendship Village Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Friendship Village Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.