NPIMap

Organization Active NPI

Kingfisher Health LLC

Doing business as Halcyon Home

  • Home Health Agency
  • San Marcos, TX
National Provider Identifier
1851861496
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
KINGFISHER HEALTH LLC
Doing business as
Halcyon Home
Practice address
125 McCarty Lane
San Marcos, TX 78666
Phone
(512) 667-6775
NPI assigned
Nov 27, 2018
Last updated
Nov 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Authorized official

Name
Amy E Sweet, PA - CNPI 1689616591
Title
Administrator
Phone
(512) 815-9009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

125 McCarty Lane
San Marcos, TX 78666

Mailing address

8133 Mesa Dr Ste 200
Austin, TX 78759-8655
Phone (512) 815-9009

Other names 1

  • Halcyon Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190506002576 TX Part A Provider - Home Health Agency 6709128028 Practice locations: San Marcos, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851861496. Details of each certification follow.

Home health agency certification: CCN 457094

Legal name
KINGFISHER HEALTH LLC
Doing business as
HALCYON HOME
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 8, 1975
Last certification
Jan 31, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 23, 2018 in TX
Enrollment address
125 W McCarty LN
Ste 200
San Marcos, TX 78666-6470

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Halcyon HomeCCN 457094 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Aug 8, 1975
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
Tax ID family
Halcyon Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

125 E McCarty LN
TX 78666

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Scott K Fichter Individual Corporate OfficerManager/Secretary Feb 11, 2019
OtherManager, President, VP, Treasure Feb 11, 2019
Amy E Sweet Individual 5% Or Greater Indirect Ownership Interest Feb 11, 2019 98%
Corporate OfficerManager, President VP, Treasurer Feb 11, 2019
OtherManager, President, VP, Treasure Feb 11, 2019
Kingfisher Health Holdings LLC Organization, Austin, TX LLC 5% Or Greater Direct Ownership Interest Feb 11, 2019 100%
Tanya Louise Roberts Individual W-2 Managing EmployeeAdministrator Feb 11, 2019
Halcyon Home LLC Organization, Austin, TX LLC 5% Or Greater Indirect Ownership Interest Feb 11, 2019 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 4

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Change-of-ownership history 1

DateEventCounterparty
Feb 11, 2019 Change of OwnershipThis provider was the buyer Central Medical Center Home HealthCCN 457094, FL, NPI 1164465944

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543276800000",
    "number": "1851861496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8133 MESA DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787598655",
            "telephone_number": "512-815-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 MCCARTY LANE",
            "city": "SAN MARCOS",
            "state": "TX",
            "postal_code": "78666",
            "telephone_number": "512-667-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGFISHER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A",
        "authorized_official_last_name": "SWEET",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-815-9009",
        "authorized_official_credential": "PA - C"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Halcyon Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Marcos, TX

Sources for this page

Verify at the official NPI Registry.