NPIMap

Organization Active NPI

Maxus Healthcare Partners LLC

Doing business as Renew Home Health

  • Home Health Agency
  • Abilene, TX
National Provider Identifier
1740716646
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAXUS HEALTHCARE PARTNERS LLC
Doing business as
Renew Home Health
Practice address
6382 Buffalo Gap Rd Ste C
Abilene, TX 79606-5937
Phone
(325) 692-9100
Fax
(325) 692-9102
NPI assigned
May 11, 2017
Last updated
Aug 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
Ms. Penny Rivera, RN
Title
Director of QM/Compliance
Phone
(817) 921-6400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X TX Primary

Addresses

Primary practice location

6382 Buffalo Gap Rd Ste C
Abilene, TX 79606-5937

Mailing address

1021 Washington Ave
Fort Worth, TX 76104-3021
Phone (817) 921-6400

Other names 1

  • Renew Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170831001939 TX Part A Provider - Home Health Agency 1759530264 Practice locations: Abilene, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740716646. Details of each certification follow.

Home health agency certification: CCN 747859

Legal name
MAXUS HEALTHCARE PARTNERS LLC
Doing business as
RENEW HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 3, 2013
Last certification
Nov 21, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 29, 2012 in TX
Enrollment address
6382 Buffalo Gap Rd
Ste C
Abilene, TX 79606-6048

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Renew Home HealthCCN 747859 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Jun 3, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, 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
45D2048037Renew Home Health6382 Buffalo Gap Rd Suite C, Abilene, TX 79606Certificate of waiverOct 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
Maxus Healthcare Partners LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6382 Buffalo Gap Rd
Ste C
Abilene, TX 79606
Phone (325) 692-9100

3305 S Mayhill Rd
Ste 125
Denton, TX 76208
Phone (940) 243-9812

1050 Forest Park Blvd
Ste 301
Fort Worth, TX 76110
Phone (866) 841-3044

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
Stevan Hammond Individual 5% Or Greater Direct Ownership InterestCeo May 25, 2017 100%
Corporate OfficerCeo May 25, 2017 50%
W-2 Managing EmployeeCeo May 25, 2017 10%
Operational/Managerial ControlCeo May 25, 2017 25%
Philip Criswell Individual Corporate OfficerCoo Jul 25, 2017 25%
W-2 Managing EmployeeCoo Jul 25, 2017 50%
Operational/Managerial ControlCoo May 27, 2017 50%
Johanna Ray Individual Corporate OfficerDirector of Nursing Jun 12, 2019 25%
Corporate DirectorDirector of Nursing Jul 25, 2017 100%
W-2 Managing EmployeeDirector of Nursing Jul 25, 2017 40%
Operational/Managerial ControlDirector of Nursing Jul 25, 2017 25%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Renew Home HealthDenton, TX, CCN 747251 Home health agency Operational/Managerial Control (100%) Jul 9, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Change-of-ownership history 1

DateEventCounterparty
May 25, 2017 Change of OwnershipThis provider was the buyer Hands of Compassion Home CareCCN 747859, TX, NPI 1013270131

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1740716646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 WASHINGTON AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043021",
            "telephone_number": "817-921-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6382 BUFFALO GAP RD STE C",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065937",
            "telephone_number": "325-692-9100",
            "fax_number": "325-692-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXUS HEALTHCARE PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "DIRECTOR OF QM/COMPLIANCE",
        "authorized_official_telephone_number": "817-921-6400",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Renew Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abilene, TX

Sources for this page

Verify at the official NPI Registry.