My Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MY HOME CARE LLC

Practice address

1037 S Broadway Ave
Wichita, KS 67211-2232

Phone

(316) 358-9423

Fax

(316) 358-9975

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Somphien Amphone, RN

Title

Admin/Owner

Phone

(316) 358-9423

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Home health agency certification: CCN 178127

Legal name

MY HOME CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 16, 2021

Last certification

Apr 16, 2021

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Jun 10, 2020 in KS

Enrollment address

1037 S Broadway Ave
Wichita, KS 67211-2232

Listed as

My Home Care LLCCCN 178127

Ownership

Proprietary

Certified

Apr 16, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, 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.

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653609600000",
    "number": "1780209882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 S BROADWAY AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112232",
            "telephone_number": "316-358-9423",
            "fax_number": "316-358-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 S BROADWAY AVE",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672112232",
            "telephone_number": "316-358-9423",
            "fax_number": "316-358-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2022-05-27",
        "certification_date": "2022-05-27",
        "status": "A",
        "authorized_official_last_name": "AMPHONE",
        "authorized_official_first_name": "SOMPHIEN",
        "authorized_official_title_or_position": "ADMIN/OWNER",
        "authorized_official_telephone_number": "316-358-9423",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.