Active NPI
Community Homecare Inc
- Home Health Agency
- Sullivan, IL
National Provider Identifier
1710973235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1010333
- Legal business name
- COMMUNITY HOMECARE INC
- Practice address
- 107 E Jefferson St
Sullivan, IL 61951-2025 - Phone
- (217) 728-2320
- Fax
- (217) 728-2305
- NPI assigned
- Sep 20, 2005
- Last updated
- Oct 20, 2026
- 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
- R Todd Scott
- Title
- Administrator
- Phone
- (217) 728-2320
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1010333 | IL | Primary |
Addresses
Primary practice location
107 E Jefferson St
Sullivan, IL 61951-2025
Mailing address
107 E Jefferson St
Sullivan, IL 61951-2025
Phone (217) 728-2320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051107000916 | IL | Part A Provider - Home Health Agency | 3577559582 | Practice locations: Sullivan, IL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1710973235. Details of each certification follow.
Home health agency certification: CCN 147774
- Legal name
- COMMUNITY HOMECARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 18, 2004
- Last certification
- Mar 18, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Nov 19, 2003 in IL
- Enrollment address
- 107 E Jefferson Street
Sullivan, IL 61951
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Community Homecare, Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jun 18, 2004
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D1023194 | Community Homecare Inc | Certificate of waiver | Mar 8, 2028 |
National Provider Directory
National Provider DirectoryLocations
107 E Jefferson St
Sullivan, IL 61951
Phone (217) 728-2320
113 E Jefferson St
Ste D
Sullivan, IL 61951
Phone (217) 728-2320
Ownership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Kelly Scott | Corporate Officer | Nov 19, 2003 | 50% |
| Corporate Director | Nov 19, 2003 | 50% | |
| W-2 Managing Employee | Nov 19, 2003 | 50% | |
| Robert Todd Scott | 5% Or Greater Direct Ownership Interest | Nov 19, 2003 | 50% |
| Corporate Officer | Nov 19, 2003 | 50% | |
| Corporate Director | Nov 19, 2003 | 50% | |
| W-2 Managing Employee | Nov 19, 2003 | 50% |
Practitioners & affiliated clinicians
Affiliated clinicians 11
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Medicine Physician
- Shelbyville, IL
- NPI 1851383418
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1792454400000",
"number": "1710973235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 E JEFFERSON ST",
"city": "SULLIVAN",
"state": "IL",
"postal_code": "619512025",
"telephone_number": "217-728-2320",
"fax_number": "217-728-2305"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E JEFFERSON ST",
"city": "SULLIVAN",
"state": "IL",
"postal_code": "619512025",
"telephone_number": "217-728-2320",
"fax_number": "217-728-2305"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COMMUNITY HOMECARE INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-20",
"last_updated": "2026-10-20",
"certification_date": "2026-10-20",
"status": "A",
"authorized_official_last_name": "SCOTT",
"authorized_official_first_name": "R TODD",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "217-728-2320"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "IL",
"license": "1010333",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sullivan, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2026; 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.