Community HCA, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

COMMUNITY HCA, INC.

Doing business as

Community Home Health Care

Practice address

4640 W Jefferson Blvd
Fort Wayne, IN 46804-6826

Phone

(260) 441-8302

Fax

(260) 441-8502

NPI assigned

May 29, 2007

Last updated

Sep 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Long

Title

Ceo

Phone

(260) 441-8302

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Community Home Health Care Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740481894. Details of each certification follow.

• CCN 157442 Home health agency · Active · Details

Home health agency certification: CCN 157442

Legal name

COMMUNITY HCA INC

Doing business as

COMMUNITY HOME HEALTH CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 19, 2009

Last certification

Sep 16, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 23, 2017 in IN

Enrollment address

4640 W Jefferson Blvd
Fort Wayne, IN 46804-6826

Listed as

Community Home Health CareCCN 157442 · All quality measures

Ownership

Proprietary

Certified

Dec 19, 2009

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

Change-of-ownership history 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sandra Kay Lortie, RN, BSN

  • Home Health Registered Nurse
  • New Haven, IN
  • NPI 1942406053
  NPD

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1740481894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046826",
            "telephone_number": "260-441-8302",
            "fax_number": "260-441-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 W JEFFERSON BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468046826",
            "telephone_number": "260-441-8302",
            "fax_number": "260-441-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HCA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "260-441-8302"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200065690A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.

Verify at the official NPI Registry.