NPIMap

Organization Active NPI

Elevate Home Health LLC

  • Home Health Agency
  • Price, UT
National Provider Identifier
1831679588
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ELEVATE HOME HEALTH LLC
Practice address
88 E 100 S
Price, UT 84501-3006
Phone
(435) 637-1250
NPI assigned
Aug 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Authorized official

Name
David Funk, OWNER
Title
Owner
Phone
(801) 850-4089

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

88 E 100 S
Price, UT 84501-3006

Mailing address

88 E 100 S
Price, UT 84501-3006
Phone (435) 637-1250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190116001032 UT Part A Provider - Home Health Agency 3476899279 Practice locations: Price, UT

Home health agency certification: CCN 467359

Legal name
ELEVATE HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 9, 2019
Last certification
Aug 9, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 26, 2018 in UT
Enrollment address
88 E 100 S
Price, UT 84501-3006

Care Compare: Home health agency

Medicare Care Compare
Listed as
Elevate Home Health, LLCCCN 467359
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Aug 9, 2019
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, 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
46D2164524Elevate Home Health88 East 100 South, Price, UT 84501Certificate of waiverApr 7, 2027

National Provider Directory

National Provider Directory

Locations

88 E 100 S
Price, UT 84501
Phone (435) 637-1250

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.

NameRoleSinceShare
Brody J Leroy Individual 5% Or Greater Direct Ownership Interest Dec 20, 2023 50%
Corporate DirectorDirector/President/OT Dec 20, 2023
W-2 Managing Employee Dec 20, 2023
Michelle Louise Willson Individual 5% Or Greater Direct Ownership Interest Dec 20, 2023 50%
Corporate DirectorVP, RN Jun 26, 2018
W-2 Managing EmployeeVP, Board Member Jun 26, 2018

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1831679588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 E 100 S",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013006",
            "telephone_number": "435-637-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E 100 S",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013006",
            "telephone_number": "435-637-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-850-4089",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

Verify at the official NPI Registry.