NPIMap

Iaatk Inc

Organization Active NPI Home Health Agency · Lompoc, CA

NPI 1750834719 · NPPES record last updated Mar 15, 2018

Key facts

NPI
1750834719
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
Legal business name
IAATK INC
Practice address
320 E Walnut Ave
Lompoc, CA 93436-6835
Phone
(805) 737-4357
NPI assigned
Jul 26, 2016
Organization subpart
No

Authorized official

Name
Mr. Pablo Sandoval Martinez
Title
President
Phone
(805) 737-4357

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 1

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

Affiliated clinicians 42

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

View all 42

Medicare Care Compare: Home health agency

Listed as
Superior Home Health CCN 559004
Overall star rating
★★★★★ 4.5 of 5
Ownership
Proprietary
Certified
Jan 21, 2019
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Home health agency certification: CCN 559004

Legal name
IAATK INC
Doing business as
SUPERIOR HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 21, 2019
Last certification
Jan 21, 2019
Ownership / control type
Proprietary
Organization structure
Corporation · Proprietary
Incorporated
May 1, 2007 in CA
Enrollment address
320 E Walnut Ave
Lompoc, CA 93436-6835
HHA Branch

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.

NameRoleSinceShare
Pablo Martinez
Individual 		5% Or Greater Direct Ownership Interest May 1, 2007 50%
Corporate Officer
President		 May 1, 2007 50%
Michelle Martinez
Individual 		5% Or Greater Direct Ownership Interest May 1, 2007 50%
Corporate Officer
Vice President		 May 1, 2007 50%
W-2 Managing Employee
Vice President		 May 1, 2007 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190425000307 CA Part a Provider - Home Health Agency 3173865094 Practice locations: Lompoc, CA

National Provider Directory

Tax ID family
Iaatk Inc (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Yes
In Home Supportive Care Agency 253Z00000X 424700001 CA

Addresses

Primary practice location

320 E Walnut Ave
Lompoc, CA 93436-6835

Mailing address

PO Box 1
Lompoc, CA 93438-0001
Phone (805) 737-4357

Other names

  • Superior Home Healh Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 15, 2018.

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521072000000",
    "number": "1750834719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934380001",
            "telephone_number": "805-737-4357",
            "fax_number": "805-735-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E WALNUT AVE",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366835",
            "telephone_number": "805-737-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IAATK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2018-03-15",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "SANDOVAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-737-4357",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CA",
            "license": "424700001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Superior Home Healh",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lompoc, CA

All providers in Lompoc, CA · Home Health Agency in California

Sources for this page

Verify at the official NPI Registry.