NPIMap

Organization Active NPI

Eminent Home Healthcare LLC

  • Home Health Agency
  • Dallas, TX
National Provider Identifier
1841492683
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
009960 Issued in TX
Legal business name
EMINENT HOME HEALTHCARE LLC
Practice address
10864 Audelia Rd
Suite 100
Dallas, TX 75238-1068
Phone
(214) 660-4404
Fax
(214) 660-4406
NPI assigned
Jun 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Authorized official

Name
Valsamma KoshyNPI 1720151194
Title
Administrator
Phone
(214) 660-4404

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 009960 TX Primary

Addresses

Primary practice location

10864 Audelia Rd
Suite 100
Dallas, TX 75238-1068

Mailing address

10864 Audelia Rd
Suite 100
Dallas, TX 75238-1068
Phone (214) 660-4404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050828000000 TX Part A Provider - Home Health Agency 3678504891 Practice locations: Dallas, TX

Home health agency certification: CCN 677937

Legal name
EMINENT HOME HEALTHCARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 23, 2006
Last certification
Mar 3, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
in TX
Enrollment address
10864 Audelia Rd 100
Dallas, TX 75238-1065
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Eminent Home Healthcare LLCCCN 677937
Ownership
Proprietary
Certified
May 23, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

10864 Audelia Rd
Ste 100
Dallas, TX 75238
Phone (214) 660-4404

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
Valsamma Koshy Individual 5% Or Greater Direct Ownership Interest Jun 21, 2005 50%
Operational/Managerial Control May 1, 2009
Koshy Kochukunju Individual 5% Or Greater Direct Ownership Interest Jun 21, 2005 50%
Corporate Director Aug 28, 2005

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434672000000",
    "number": "1841492683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10864 AUDELIA RD",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752381068",
            "telephone_number": "214-660-4404",
            "fax_number": "214-660-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10864 AUDELIA RD",
            "address_2": "SUITE 100",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752381068",
            "telephone_number": "214-660-4404",
            "fax_number": "214-660-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMINENT HOME HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2015-06-19",
        "status": "A",
        "authorized_official_last_name": "KOSHY",
        "authorized_official_first_name": "VALSAMMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-660-4404"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "009960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.