NPIMap

Organization Active NPI

901 Home Health Care LLC

  • Home Health Agency
  • Memphis, TN
National Provider Identifier
1831976497
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
901 HOME HEALTH CARE LLC
Practice address
515 Monteigne Blvd
Memphis, TN 38103-8731
Phone
(901) 361-5144
NPI assigned
Sep 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Dr. Kelsey Defreece, OTD, OTR/LNPI 1508417437
Title
Occupational Therapist / Owner
Phone
(901) 361-5144

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 Primary

Addresses

Primary practice location

515 Monteigne Blvd
Memphis, TN 38103-8731

Mailing address

515 Monteigne Blvd
Memphis, TN 38103-8731
Phone (901) 361-5144

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240205003426 TN Part A Provider - Home Health Agency 9931542172 Practice locations: Collierville, TN

Home health agency certification: CCN 447827

Legal name
901 HOME HEALTH CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 23, 2024
Last certification
Apr 23, 2024
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 8, 2023 in TN
Enrollment address
1010 Cypress Run Dr
Collierville, TN 38017-3768

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kelsey Defreece Individual 5% Or Greater Direct Ownership Interest Dec 20, 2023 100%
Operational/Managerial ControlOwner / Manager Dec 20, 2023 100%

Practitioners 1

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

Affiliated clinicians 12

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
901 Home Health Care, LLCCCN 447827
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Apr 23, 2024
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, 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
44D2300558901 Home Health Care515 Monteigne Blvd, Memphis, TN 38103Certificate of waiverMar 12, 2028

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1831976497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MONTEIGNE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381038731",
            "telephone_number": "901-361-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MONTEIGNE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381038731",
            "telephone_number": "901-361-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "901 HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-08",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "DEFREECE",
        "authorized_official_first_name": "KELSEY",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST / OWNER",
        "authorized_official_telephone_number": "901-361-5144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OTD, OTR/L"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.