NPIMap

Organization Active NPI

Fort Payne Home Care, LLC

  • Home Health Agency
  • Fort Payne, AL
National Provider Identifier
1790720076
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
CON1340 Issued in AL
Legal business name
FORT PAYNE HOME CARE, LLC
Practice address
1706 Glenn Blvd SW Ste 3
Fort Payne, AL 35968-3544
Phone
(256) 844-2882
Fax
(256) 844-6591
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Mr. Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X AL
Home Health Agency 251E00000X CON1340 AL Primary

Addresses

Primary practice location

1706 Glenn Blvd SW Ste 3
Fort Payne, AL 35968-3544

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other identifiers 1

IdentifierTypeStateIssuer
DEK7093AMedicaidAL

Other names 1

  • Alabama HomeCare of Fort Payne Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080125000313 AL Part A Provider - Home Health Agency 4880605674 Practice locations: Fort Payne, AL

Home health agency certification: CCN 017093

Legal name
FORT PAYNE HOME CARE LLC
Doing business as
ALABAMA HOMECARE OF FORT PAYNE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 30, 1992
Last certification
Jun 25, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 28, 2016 in AL
Enrollment address
1706 Glenn Blvd SW
Ste 3
Fort Payne, AL 35968-3544

Care Compare: Home health agency

Medicare Care Compare
Listed as
Alabama Homecare Fort PayneCCN 017093
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jul 30, 1992
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
01D1002212Fort Payne Home Care, LLC1706 Glenn Blvd SW Suite 3, Fort Payne, AL 35968Certificate of waiverJul 31, 2026

National Provider Directory

National Provider Directory

Locations

13280 County Road 51
Collinsville, AL 35961
Phone (256) 524-2411

1706 Glenn Blvd SW
Ste 3
Fort Payne, AL 35968
Phone (256) 844-2882

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCoo Apr 13, 2026
W-2 Managing EmployeeCoo Apr 13, 2026
Joni Babineaux Individual Corporate OfficerCfo Apr 13, 2026
Afam Holding Co LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Mar 1, 2019 100%
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2019
Joshua Lee Proffitt Individual Corporate OfficerPresident Apr 30, 2018
Corporate DirectorPresident/ Ceo Apr 30, 2018
Almost Family, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2019 100%
Stephanie Hughes Individual W-2 Managing EmployeeAdministrator / Director of Nursing Apr 11, 2022
National Health Industries, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Mar 1, 2019 80%
Afam Sub I LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Mar 1, 2019 20%
Amy Cormier Individual Corporate DirectorDirector of Managed Care May 1, 2025

Facilities with the same owner 111

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

View all 111

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1790720076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 GLENN BLVD SW STE 3",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683544",
            "telephone_number": "256-844-2882",
            "fax_number": "256-844-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PAYNE HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AL",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AL",
            "license": "CON1340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DEK7093A",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alabama HomeCare of Fort Payne",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alabama HomeCare of Fort Payne",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.