Organization Active NPI

Ahcck LLC

Doing business as Country Home Health Care

  • Home Health Agency
  • Elk Grove, CA
National Provider Identifier
1841297157
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
100000487 Issued in CA
Legal business name
AHCCK LLC
Doing business as
Country Home Health Care
Practice address
9370 W Stockton Blvd
Ste 130
Elk Grove, CA 95758-8013
Phone
(916) 691-4100
Fax
(916) 691-4111
NPI assigned
Jun 30, 2005
Last updated
Jun 10, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ROCKY MOUNTAIN HOME HEALTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Mr. Dee R Bangerter
Title
Ceo/President
Phone
(801) 397-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 100000487 CA Primary

Addresses

Primary practice location

9370 W Stockton Blvd
Ste 130
Elk Grove, CA 95758-8013

Mailing address

576 W. 900 S.
Suite 260
Wood Cross, UT 84010-8127
Phone (801) 397-4054

Other identifiers 3

IdentifierTypeStateIssuer
HHA07404GMedicaidCA
CGP166248OtherCACALIFORNIA CHILDREN SERVICES
ZZZ03663ZOtherCABLUE SHIELD OF CALIFORNIA

Other names 1

  • Country Home Health Care Doing business as

National Provider Directory

National Provider Directory

Locations

9370 W Stockton Blvd
Ste 130
Elk Grove, CA 95758
Phone (916) 647-4044

245 New York Ranch Rd
Ste C
Jackson, CA 95642
Phone (209) 223-3866

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1841297157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 W. 900 S.",
            "address_2": "SUITE 260",
            "city": "WOOD CROSS",
            "state": "UT",
            "postal_code": "840108127",
            "telephone_number": "801-397-4054",
            "fax_number": "801-397-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9370 W STOCKTON BLVD",
            "address_2": "STE 130",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957588013",
            "telephone_number": "916-691-4100",
            "fax_number": "916-691-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHCCK LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROCKY MOUNTAIN HOME HEALTH, LLC",
        "enumeration_date": "2005-06-30",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "BANGERTER",
        "authorized_official_first_name": "DEE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "801-397-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "100000487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA07404G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CHILDREN SERVICES",
            "identifier": "CGP166248",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ03663Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Country Home Health Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.