Vineyard Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VINEYARD HOME HEALTH LLC

Practice address

1510 W Jefferson St
Waxahachie, TX 75165-2234

Phone

(972) 521-3353

Fax

(972) 586-7510

NPI assigned

Jan 2, 2020

Organization subpart

No

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

Authorized official

Name

Jake Hibbard

Title

Owner

Phone

(409) 256-2909

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 747998

Legal name

VINEYARD HOME HEALTH LLC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 19, 2021

Last certification

Jan 19, 2021

Ownership / control type

Proprietary

Organization structure

Not SelectedProprietary

Incorporated

Dec 31, 2019 in TX

Enrollment address

1510 W Jefferson St
Waxahachie, TX 75165-2234

Listed as

Vineyard Home Health LLCCCN 747998 · All quality measures

Overall star rating

3 of 5

Ownership

Proprietary

Certified

Jan 19, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1841839214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 W JEFFERSON ST",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751652234",
            "telephone_number": "972-521-3353",
            "fax_number": "972-586-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 W JEFFERSON ST",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751652234",
            "telephone_number": "972-521-3353",
            "fax_number": "972-586-7510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINEYARD HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "HIBBARD",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-256-2909"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Rebecca Via-Reque, PA-C
• Megan Vidales, DC
• Tammy Villanueva, PHD, LPC-S
• Antoinette R Vincent, LPC
• Duane F Vincent, D.C.
• Sheila Marie Vinson, NP
• Kim Vu, CNIM
• W. Griggs Dehay D.D.S., Inc.
• Haley Elyse Wagner, D.O.
• Victoria Elizabeth Wahlenmaier, DNP, APRN, FNP-BC

• Home Health Agency in Waxahachie, TX
• Providers in Waxahachie, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.

Verify at the official NPI Registry.