Amicita Home Health, LLC
Organization Active NPI Home Health Agency · Vidalia, GA
NPI 1851461735 · NPPES record last updated Mar 23, 2017
Key facts
- NPI
- 1851461735
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 132-013 (GA)
- Legal business name
- AMICITA HOME HEALTH, LLC
- Practice address
- 806 Maple Dr
Vidalia, GA 30474-7208 - Phone
- (912) 538-8000
- Fax
- (912) 538-8000
- NPI assigned
- Nov 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sarah A Thompson
- Title
- VP of Operations
- Phone
- (912) 538-8000
Owners & managing parties with NPI records 1
-
Dave A Ringer, MD
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 1
Facilities with the same owner 11
Affiliated clinicians 12
-
Heywood Kyle Gay, MD
-
Sydney Lance Hendrix, M.D.
-
Blake E Milner, M.D.
-
Misty Denise Poole, M.D.
-
Ronnie R Smith, M. D.
-
Edward F Stringer IV, M.D.
-
Paul W Thompson, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Chsga Home Health
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- May 23, 1979
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Physical therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0886833 | Amicita Home Health, LLC | Certificate of waiver | May 26, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Home health agency certification: CCN 117054
- Legal name
- AMICITA HOME HEALTH LLC
- Doing business as
- CHSGA HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- May 23, 1979
- Last certification
- Oct 10, 2019
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Non-profit
- Incorporated
- Dec 29, 2009 in GA
- Enrollment address
- 806 Maple Dr
Vidalia, GA 30474-7208
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Home and Community Services Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2021 | 100% |
| Dave a Ringer |
Contracted Managing Employee |
Feb 1, 2017 | |
| Leigh Ann Beck |
Corporate Officer |
Feb 4, 2024 | 100% |
| W-2 Managing Employee |
Feb 4, 2024 | 100% | |
| Michelle Moore-Andrews |
Corporate Officer |
Oct 19, 2023 | 100% |
| W-2 Managing Employee |
Oct 19, 2023 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100914000137 | GA | Part a Provider - Home Health Agency | 3870618903 | Practice locations: Vidalia, GA |
National Provider Directory
- Tax ID family
- Amicita Home Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 132-013 | GA | Yes |
Addresses
Primary practice location
806 Maple Dr
Vidalia, GA 30474-7208
Mailing address
806 Maple Drive
Vidalia, GA 30474-7208
Phone (912) 538-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 117054 | Other | MEDICARE HOME HEALTH |
Other providers in Vidalia, GA
- Allmond & Whipple, Inc.
- Allmond & Whipple, Inc.
- Allmond & Whipple, Inc.
- Amedisys Georgia, L.L.C.
- American Oncology Partners, P.a.
- Anchored Minds Behavioral Health LLC
- Taylor Alexandria Andre
- Mary Frances Andrews
- Ara-Vidalia Clinic LLC
- Robert Lee Arnold
All providers in Vidalia, GA · Home Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.