Active NPI
Frontier Home Health, LLC
- Home Health Agency
- Pueblo, CO
National Provider Identifier
1821312638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- FRONTIER HOME HEALTH, LLC
- Practice address
- 1301 Fortino Blvd
Pueblo, CO 81008-2032 - Phone
- (719) 544-5891
- Fax
- (719) 544-5895
- NPI assigned
- Mar 23, 2010
- Last updated
- Oct 12, 2026
- 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
- Mr. Larry Dewayne Russell
- Title
- Ceo
- Phone
- (719) 544-5891
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
1301 Fortino Blvd
Pueblo, CO 81008-2032
Mailing address
4718 N Elizabeth St Ste a
Pueblo, CO 81008-2080
Phone (719) 544-5891
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120327000487 | CO | Part A Provider - Home Health Agency | 0547420689 | Practice locations: Pueblo, CO |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1821312638. Details of each certification follow.
Home health agency certification: CCN 067501
- Legal name
- FRONTIER HOME HEALTH, LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Aug 24, 2012
- Last certification
- Oct 19, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Enrollment address
- 4718 N Elizabeth St
Ste a
Pueblo, CO 81008-2080
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Frontier Home Health LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Aug 24, 2012
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Frontier Home Health LLC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Pueblo, CO
- NPI 1114552288
-
- In Home Supportive Care Agency
- Pueblo, CO
- NPI 1306639604
Locations
4718 N Elizabeth St
Ste A
Pueblo, CO 81008
Phone (719) 544-5891
503 N Main St
Ste 103-W
Pueblo, CO 81003
Phone (719) 544-5891
Ownership & related parties
All disclosed owners & managing parties 6
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 |
|---|---|---|---|
| Larry D. Russell | 5% Or Greater Direct Ownership Interest | Mar 3, 2010 | 40% |
| Corporate Officer | Mar 3, 2011 | ||
| Potaos Holdings LP | 5% Or Greater Direct Ownership Interest | Mar 3, 2010 | 25% |
| Robert K. Mehlman | 5% Or Greater Direct Ownership Interest | Mar 3, 2010 | 35% |
| Michelle J Bickford | Corporate Director | Sep 16, 2011 | |
| Operational/Managerial Control | Sep 16, 2011 | ||
| Kevin T Mehlman | 5% Or Greater Indirect Ownership Interest | Mar 3, 2010 | |
| Cassy Schilling | W-2 Managing Employee | Apr 19, 2021 | |
| Operational/Managerial Control | Apr 19, 2021 |
Practitioners & affiliated clinicians
Affiliated clinicians 7
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": "1269302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1791763200000",
"number": "1821312638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4718 N ELIZABETH ST STE A",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082080",
"telephone_number": "719-544-5891",
"fax_number": "719-544-5895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 FORTINO BLVD",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810082032",
"telephone_number": "719-544-5891",
"fax_number": "719-544-5895"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRONTIER HOME HEALTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-23",
"last_updated": "2026-10-12",
"certification_date": "2026-10-12",
"status": "A",
"authorized_official_last_name": "RUSSELL",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "DEWAYNE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "719-544-5891",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2026; 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.