NPIMap

Organization Active NPI

Legacy Homecare Associates, LLC

Doing business as LifeSpring Home Care

  • Home Health Agency
  • Pauls Valley, OK
National Provider Identifier
1730488131
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LEGACY HOMECARE ASSOCIATES, LLC
Doing business as
LifeSpring Home Care
Practice address
106 N Cedar St
Pauls Valley, OK 73075-2805
Phone
(405) 207-9496
Fax
(405) 207-9701
NPI assigned
Mar 24, 2011
Last updated
May 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

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

Authorized official

Name
Karen E Vahlberg, RN
Title
Chief Executive Officer
Phone
(405) 329-4545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

106 N Cedar St
Pauls Valley, OK 73075-2805

Mailing address

2411 Springer Dr
Norman, OK 73069-3955
Phone (405) 329-4545

Other names 1

  • LifeSpring Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110622000183 OK Part A Provider - Home Health Agency 3577741586 Practice locations: Pauls Valley, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730488131. Details of each certification follow.

Home health agency certification: CCN 377757

Legal name
LEGACY HOMECARE ASSOCIATES, LLC
Doing business as
LIFESPRING HOME CARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 30, 2012
Last certification
Jan 11, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 7, 2011 in OK
Enrollment address
106 N Cedar
Pauls Valley, OK 73075

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lifespring Home CareCCN 377757 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Mar 30, 2012
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1416 N Porter Ave
Norman, OK 73071
Phone (405) 928-5533

507 S Willow St
Ste B1
Pauls Valley, OK 73075
Phone (405) 207-9496

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Julie a Clarkson Individual Corporate OfficerCfo Apr 1, 2024
Lawana G Nelson Individual Corporate OfficerChief Clinical Officer Apr 1, 2024
The Deaconess Associations Inc Organization, Cincinnati, OH Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Nov 12, 2021 100%
Deaconess Healthcare Holdings, Inc. Organization, Cincinnati, OH Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Nov 12, 2021 100%
Lifespring Home Care and Hospice, LLC Organization, Norman, OK LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Nov 12, 2021 100%
Operational/Managerial Control Jan 1, 2020 100%
Meranda Roberts Individual Corporate OfficerChief Sales Officer Apr 1, 2024
Erik K Drennen Individual Corporate OfficerPresident and Ceo Apr 1, 2024
W-2 Managing EmployeePresident and Ceo Apr 1, 2024

Facilities with the same owner 37

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

View all 37

Practitioners & affiliated clinicians

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1730488131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2411 SPRINGER DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730693955",
            "telephone_number": "405-329-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N CEDAR ST",
            "city": "PAULS VALLEY",
            "state": "OK",
            "postal_code": "730752805",
            "telephone_number": "405-207-9496",
            "fax_number": "405-207-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HOMECARE ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "VAHLBERG",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "405-329-4545",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LifeSpring Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pauls Valley, OK

Sources for this page

Verify at the official NPI Registry.