NPIMap

Organization Active NPI

Jefferson Regional Homecare, LLC

Doing business as Jefferson HomeCare

  • Home Health Agency
  • White Hall, AR
National Provider Identifier
1891972642
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
JEFFERSON REGIONAL HOMECARE, LLC
Doing business as
Jefferson HomeCare
Practice address
232 Frankie LN
White Hall, AR 71602-2699
Phone
(870) 534-3420
Fax
(870) 534-4843
NPI assigned
Jan 23, 2008
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

232 Frankie LN
White Hall, AR 71602-2699

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

2720 W 28th Ave
Pine Bluff, AR 71603-4919
Phone (870) 534-3420

Other names 1

  • Jefferson HomeCare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080812000643 AR Part A Provider - Home Health Agency 4183799026 Practice locations: White Hall, AR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891972642. Details of each certification follow.

Home health agency certification: CCN 047093

Legal name
JEFFERSON REGIONAL HOMECARE, LLC
Doing business as
JEFFERSON HOMECARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 27, 1984
Last certification
Jul 17, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Dec 26, 2007 in AR
Enrollment address
232 Frankie LN
White Hall, AR 71602-2699

Care Compare: Home health agency

Medicare Care Compare
Listed as
Jefferson HomecareCCN 047093 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Dec 27, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D1089240Jefferson Homecare232 Frankie Lane, White Hall, AR 71602Certificate of waiverSep 11, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1718 Doctors Dr
Pine Bluff, AR 71603
Phone (870) 541-7210

232 Frankie Ln
White Hall, AR 71602
Phone (870) 534-3420

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Arkansas Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Jun 1, 2008 67%
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 67%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Rebecca S Blevins Individual W-2 Managing EmployeeAdministrator / Director of Nursing Nov 7, 2021
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
Wendy S Daigle Individual OtherDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2008 67%
Joshua Lee Proffitt Individual Corporate OfficerCeo Aug 1, 2012
Jefferson Hospital Association, Inc Organization, Pine Bluff, AR Corporation 5% Or Greater Direct Ownership Interest Jun 1, 2008 33%

Owners & managing parties with NPI records 9

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

Facilities with the same owner 26

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

View all 26

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 60

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

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1891972642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022699",
            "telephone_number": "870-534-3420",
            "fax_number": "870-534-4843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 W 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Pine Bluff",
            "state": "AR",
            "postal_code": "716034919",
            "country_code": "US",
            "telephone_number": "870-534-3420",
            "fax_number": "870-534-4843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEFFERSON REGIONAL HOMECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jefferson HomeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson HomeCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in White Hall, AR

Sources for this page

Verify at the official NPI Registry.