NPIMap

Organization Active NPI

Wichita Home Health Service, Inc.

  • Home Health Agency
  • Wichita Falls, TX
National Provider Identifier
1801893334
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
001943 Issued in TX
Legal business name
WICHITA HOME HEALTH SERVICE, INC.
Practice address
4245 Kemp Blvd Ste 420
Wichita Falls, TX 76308-2833
Phone
(940) 322-7113
Fax
(940) 766-6025
NPI assigned
Jun 30, 2005
Last updated
Jun 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Chrystal S Everett, BSHCA
Title
Administrator
Phone
(940) 322-7113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 001943 TX Primary

Addresses

Primary practice location

4245 Kemp Blvd Ste 420
Wichita Falls, TX 76308-2833

Mailing address

4245 Kemp Blvd Ste 420
Wichita Falls, TX 76308-2833
Phone (940) 322-7113

Other identifiers 3

IdentifierTypeStateIssuer
001943OtherTXSTATE LICENSE NUMBER
023500401MedicaidTX
45-7047OtherTXMEDICARE PROVIDER 45-7047

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090303000479 TX Part A Provider - Home Health Agency 3678639481 Practice locations: Wichita Falls, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801893334. Details of each certification follow.

Home health agency certification: CCN 457047

Legal name
WICHITA HOME HEALTH SERVICE, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 1, 1969
Last certification
Feb 1, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 15, 1988 in TX
Enrollment address
4245 Kemp Blvd
Suite 420
Wichita Falls, TX 76308-2833

Care Compare: Home health agency

Medicare Care Compare
Listed as
Wichita Home Health Service IncCCN 457047 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
May 1, 1969
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
45D0719841Wichita Home Health Service, Inc4245 Kemp Blvd Suite 420, Wichita Falls, TX 76308Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

4245 Kemp Blvd
Ste 120
Wichita Falls, TX 76308
Phone (940) 322-7113

4245 Kemp Blvd
Ste 420
Wichita Falls, TX 76308
Phone (940) 322-7113

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
Cynthia Bragg Individual 5% Or Greater Direct Ownership Interest Mar 10, 2023 41%
Corporate Officer Mar 10, 2023
Corporate Director Mar 10, 2023
W-2 Managing Employee Mar 10, 2023
Operational/Managerial Control Mar 10, 2023
Rebecca Chester Individual 5% Or Greater Direct Ownership Interest Mar 10, 2023 51%
Corporate Officer Mar 10, 2023
Beverly Thompson Individual 5% Or Greater Direct Ownership InterestDirector of Clinical Operations Mar 10, 2023 8%
Corporate Director Jun 1, 1994
W-2 Managing Employee Nov 16, 2009

Practitioners & affiliated clinicians

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.

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1801893334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 KEMP BLVD STE 420",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082833",
            "telephone_number": "940-322-7113",
            "fax_number": "940-766-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 KEMP BLVD STE 420",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763082833",
            "telephone_number": "940-322-7113",
            "fax_number": "940-766-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WICHITA HOME HEALTH SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-30",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "EVERETT",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "940-322-7113",
        "authorized_official_credential": "BSHCA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "001943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "001943",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023500401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER 45-7047",
            "identifier": "45-7047",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.