Active NPI
Premier Home Health Inc
- Case Management Agency
- Thayne, WY
National Provider Identifier
1902841000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Legal business name
- PREMIER HOME HEALTH INC
- Practice address
- 487A North Main St
Suite #2
Thayne, WY 83127 - Phone
- (307) 883-5500
- Fax
- (307) 883-5501
- NPI assigned
- Jun 20, 2006
- Last updated
- Apr 17, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Catherine E Cole, RN
- Title
- Administrator
- Phone
- (307) 883-5500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | NU | Primary | |
| Home Health Agency | 251E00000X | 06202 | WY |
Addresses
Primary practice location
487A North Main St
Suite #2
Thayne, WY 83127
Mailing address
PO Box 999
Thayne, WY 83127
Phone (307) 883-5500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 115705100 | Medicaid | WY | |
| 115705101 | Other | WY | MEDICAID WAIVER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080730000054 | WY | Part A Provider - Home Health Agency | 2860566502 | Practice locations: Thayne, WY |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1902841000. Details of each certification follow.
Home health agency certification: CCN 537304
- Legal name
- PREMIER HOME HEALTH INC
- Doing business as
- PREMIER HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 14, 2000
- Last certification
- Dec 19, 2018
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Nov 1, 1999 in WY
- Enrollment address
- 487A N Main St
Ste 2
Thayne, WY 83127-9768
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Premier Home Health Inc
- Overall star rating
- Ownership
- Proprietary
- Certified
- Sep 14, 2000
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 53D1096331 | Premier Home Health | Certificate of waiver | Mar 2, 2027 |
National Provider Directory
National Provider DirectoryLocations
122 Petersen Pkwy
Ste 2
Thayne, WY 83127
Phone (307) 883-5500
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Catherine Cole | 5% Or Greater Direct Ownership Interest | Nov 1, 1999 | 50% |
| Corporate Officer | Jan 1, 2000 | ||
| Corporate Director | Nov 1, 1999 | ||
| W-2 Managing Employee | Nov 1, 1999 | ||
| Charles Cole | 5% Or Greater Indirect Ownership Interest | Nov 1, 1999 | 50% |
| Corporate Officer | Nov 1, 1999 |
Practitioners & affiliated clinicians
Affiliated clinicians 5
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1429228800000",
"number": "1902841000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 999",
"city": "THAYNE",
"state": "WY",
"postal_code": "83127",
"telephone_number": "307-883-5500",
"fax_number": "307-883-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "487A NORTH MAIN ST",
"address_2": "SUITE #2",
"city": "THAYNE",
"state": "WY",
"postal_code": "83127",
"telephone_number": "307-883-5500",
"fax_number": "307-883-5501"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIER HOME HEALTH INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-20",
"last_updated": "2015-04-17",
"status": "A",
"authorized_official_last_name": "COLE",
"authorized_official_first_name": "CATHERINE",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "307-883-5500",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WY",
"license": "06202",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "115705100",
"state": "WY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID WAIVER",
"identifier": "115705101",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Thayne, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.