NPIMap

Organization Active NPI

Mesa View Home Care, LLC

  • Home Health Agency
  • Mesquite, NV
National Provider Identifier
1811174196
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MESA VIEW HOME CARE, LLC
Practice address
330 Falcon Ridge Pkwy Ste 200
Suite a
Mesquite, NV 89027-8881
Phone
(702) 346-2460
Fax
(702) 346-2466
NPI assigned
Jan 29, 2008
Last updated
Jan 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Authorized official

Name
Ty S. Wakefield, MSPTNPI 1689705758
Title
Ceo/Member
Phone
(702) 346-2460

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

330 Falcon Ridge Pkwy Ste 200
Suite a
Mesquite, NV 89027-8881

Mailing address

PO Box 1887
Mesquite, NV 89024-1887
Phone (702) 346-2460

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080325000722 NV Part A Provider - Home Health Agency 8820174295 Practice locations: Mesquite, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811174196. Details of each certification follow.

Home health agency certification: CCN 297160

Legal name
MESA VIEW HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 20, 2009
Last certification
May 14, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 30, 2008 in NV
Enrollment address
330 Falcon Ridge Pkwy Building 200
Ste a
Mesquite, NV 89027-5813

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mesa View Home Care LLCCCN 297160 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Jan 20, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Mesa View Home Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

330 Falcon Ridge Pkwy
Ste 200STEA
Mesquite, NV 89027

330 Falcon Ridge Pkwy
Ste A
Mesquite, NV 89027

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
Travis Wakefield Individual 5% Or Greater Direct Ownership Interest Jan 30, 2008 33.33%
W-2 Managing EmployeeCfo Jan 30, 2008 33.33%
Ty Wakefield Individual 5% Or Greater Direct Ownership Interest Jan 30, 2008 33.33%
W-2 Managing EmployeeCeo Jan 30, 2008 33.33%
Teresa D Bowen Individual 5% Or Greater Direct Ownership Interest Jan 30, 2008 33.33%
W-2 Managing EmployeeAdministrator Jan 30, 2008 33.33%

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 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390435200000",
    "number": "1811174196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890241887",
            "telephone_number": "702-346-2460",
            "fax_number": "702-346-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 FALCON RIDGE PKWY STE 200",
            "address_2": "SUITE A",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278881",
            "telephone_number": "702-346-2460",
            "fax_number": "702-346-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA VIEW HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2014-01-23",
        "status": "A",
        "authorized_official_last_name": "WAKEFIELD",
        "authorized_official_first_name": "TY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CEO/MEMBER",
        "authorized_official_telephone_number": "702-346-2460",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, NV

Sources for this page

Verify at the official NPI Registry.