Omni Home Health- Hernando, LLC
Organization Active NPI Home Health Agency · Palatka, FL
NPI 1902835804 · NPPES record last updated Jun 8, 2012
Key facts
- NPI
- 1902835804
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 299992387 (FL)
- Legal business name
- OMNI HOME HEALTH- HERNANDO, LLC
- Practice address
- 700 Zeagler Dr
Suite 6
Palatka, FL 32177-6806 - Phone
- (386) 312-0646
- Fax
- (386) 325-4460
- NPI assigned
- Jul 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Amanda McFaddin
- Title
- Director of Licensing/Accreditation
- Phone
- (615) 712-2250
Other NPIs on the same Medicare enrollment 5
Affiliated clinicians 19
-
Ernesto Alonso, MD
-
Teresa Freeland Barr, ARNP
-
Madeleine Rae Chewning, APRN
-
Holly Darlene Garver, APRN
-
Peter W Giebeig Jr., M.D.
-
Jan Kenneth Gonzales, FNP-C
-
Malik M. Naqi, MD
-
John P Odonnell, PA-C
-
Alecksandra Pantoja, APRN
-
Amber Pitman, M.D.
-
Rick Paul Sessions, PA-C
-
Renaldas Smidtas, MD
-
Christina Nichole Thomas, APRN
-
Kyle B Wright, PA-C
-
Amanda Nicole Zajchowski, APRN
Medicare Care Compare: Home health agency
- Listed as
- Suncrest Omni
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Feb 14, 2002
- Medicare certification status
- Active
- Services
- Nursing, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Home health agency certification: CCN 107690
- Legal name
- OMNI HOME HEALTH- HERNANDO, LLC
- Doing business as
- SUNCREST OMNI
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 14, 2002
- Last certification
- Dec 7, 2018
- Ownership / control type
- Proprietary
- Organization structure
- LLC · Proprietary
- Incorporated
- Aug 6, 2001 in FL
- Enrollment address
- 426 SW Commerce Dr
Ste 110
Lake City, FL 32025-1506
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Omni Home Health Services LLC |
5% Or Greater Direct Ownership Interest | Dec 7, 2013 | 100% |
| Omni Home Health Holdings Inc |
5% Or Greater Indirect Ownership Interest | Dec 7, 2013 | 100% |
| Nicholas Gachassin |
Corporate Officer |
Dec 1, 2019 | |
| LHC Group Inc |
5% Or Greater Indirect Ownership Interest | Apr 1, 2018 | 100% |
| Joshua Lee Proffitt |
Corporate Officer |
Apr 30, 2018 | |
| Almost Family, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 7, 2013 | 100% |
| National Health Industries, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 7, 2013 | 100% |
| Michelle Douglas |
W-2 Managing Employee |
Oct 8, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050524000420 | FL | Part a Provider - Home Health Agency | 7810939568 |
5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lake City, FL; Newberry, FL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 299992387 | FL | Yes |
Addresses
Primary practice location
700 Zeagler Dr
Suite 6
Palatka, FL 32177-6806
Mailing address
510 Hospital Dr
Suite 150
Madison, TN 37115-5033
Phone (615) 627-9267
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004157005 | Medicaid | FL |
Other names
- SunCrest OMNI
Other providers in Palatka, FL
- Geoffrey O'Donoghue
- OB & GYN of N E FL PA
- Catharina Jacoba Oberholzer
- Obstetrics & Gynecology Associates of St. Augustine, LLC
- Karen Ruth Okelly
- Optical Shop of Palatka Inc
- Orlando Clinic for Asthma&Respiratory Disease
- Hezekiah George Owojuyigbe
- Irena Maria Pacanowska-Assefa
- Anthony J Pacitti
All providers in Palatka, FL · Home Health Agency in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2012. 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.