Active NPI
CBL Medical Enterprises, Inc.
Doing business as Advantage Plus Homecare
- Home Health Agency
- Nacogdoches, TX
National Provider Identifier
1811205370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 013780
- Legal business name
- CBL MEDICAL ENTERPRISES, INC.
- Doing business as
- Advantage Plus Homecare
- Practice address
- 2719 Westward Dr
Nacogdoches, TX 75964-1229 - Phone
- (936) 559-9480
- Fax
- (936) 559-9498
- NPI assigned
- Sep 17, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charles Frazier
- Title
- Cfo/Alternate Administrator
- Phone
- (939) 559-9480
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 013780 | TX | Primary |
Addresses
Primary practice location
2719 Westward Dr
Nacogdoches, TX 75964-1229
Mailing address
2719 Westward Dr
Nacogdoches, TX 75964-1229
Phone (936) 559-9480
Other names 1
- Advantage Plus Homecare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110727000063 | TX | Part A Provider - Home Health Agency | 4688842297 | Practice locations: Nacogdoches, TX |
Home health agency certification: CCN 747683
- Legal name
- CBL MEDICAL ENTERPRISES, INC.
- Doing business as
- ADVANTAGE PLUS HOMECARE
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jan 4, 2012
- Last certification
- Oct 1, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Sep 1, 2010 in TX
- Enrollment address
- 2719 Westward Drive
Nacogdoches, TX 75964-1229
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Advantage Plus Homecare
- Overall star rating
- Ownership
- Proprietary
- Certified
- Jan 4, 2012
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2016063 | CBL Medical Enterprises Inc Dba | Certificate of waiver | Nov 9, 2026 |
National Provider Directory
National Provider DirectoryLocations
2719 Westward Dr
Nacogdoches, TX 75964
Phone (936) 559-9480
Ownership & related parties
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Charles Frazier | 5% Or Greater Direct Ownership Interest | Mar 15, 2018 | 67% |
| Corporate Director | Mar 15, 2018 | 67% | |
| W-2 Managing Employee | Mar 15, 2018 | 67% | |
| Lori D Reynolds | 5% Or Greater Direct Ownership Interest | Jan 12, 2011 | 33% |
| Corporate Officer | Jan 12, 2011 | 33% | |
| Corporate Director | Jan 12, 2011 | 33% | |
| W-2 Managing Employee | Jan 12, 2011 | 33% |
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Nacogdoches, TX
- NPI 1124020631
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1434412800000",
"number": "1811205370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2719 WESTWARD DR",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759641229",
"telephone_number": "936-559-9480",
"fax_number": "936-559-9498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2719 WESTWARD DR",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759641229",
"telephone_number": "936-559-9480",
"fax_number": "936-559-9498"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CBL MEDICAL ENTERPRISES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-09-17",
"last_updated": "2015-06-16",
"status": "A",
"authorized_official_last_name": "FRAZIER",
"authorized_official_first_name": "CHARLES",
"authorized_official_title_or_position": "CFO/ALTERNATE ADMINISTRATOR",
"authorized_official_telephone_number": "939-559-9480"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "TX",
"license": "013780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Advantage Plus Homecare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Nacogdoches, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.