NPIMap

Organization Active NPI

Omni Home Health- Hernando, LLC

Doing business as SunCrest OMNI

  • Home Health Agency
  • Lake City, FL
National Provider Identifier
1902853708
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299991704 Issued in FL
Legal business name
OMNI HOME HEALTH- HERNANDO, LLC
Doing business as
SunCrest OMNI
Practice address
1037 W US Highway 90
Suite 140
Lake City, FL 32055-3739
Phone
(386) 754-6671
Fax
(386) 754-8673
NPI assigned
May 27, 2006
Last updated
Jun 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Authorized official

Name
Amanda McFaddin
Title
Director of Licensing/Accreditation
Phone
(615) 712-2250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299991704 FL Primary

Addresses

Primary practice location

1037 W US Highway 90
Suite 140
Lake City, FL 32055-3739

Mailing address

510 Hosptial Drive
Suite 150
Madison, TN 37115-5036
Phone (615) 627-9267

Other identifiers 1

IdentifierTypeStateIssuer
004157002MedicaidFL

Other names 1

  • SunCrest OMNI Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902853708. Details of each certification follow.

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
LLCProprietary
Incorporated
Aug 6, 2001 in FL
Enrollment address
426 SW Commerce Dr
Ste 110
Lake City, FL 32025-1506
HHA Branch

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Suncrest OmniCCN 107690 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Feb 14, 2002
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

1037 W US Highway 90
Ste 140
Lake City, FL 32055
Phone (386) 719-9663

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Omni Home Health Services LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Dec 7, 2013 100%
Omni Home Health Holdings Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Nicholas Gachassin Individual Corporate OfficerSecretary / Treasurer Dec 1, 2019
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Apr 30, 2018
Almost Family, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
National Health Industries, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 7, 2013 100%
Michelle Douglas Individual W-2 Managing EmployeeAdministrator Oct 8, 2022

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339545600000",
    "number": "1902853708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 HOSPTIAL DRIVE",
            "address_2": "SUITE 150",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155036",
            "telephone_number": "615-627-9267",
            "fax_number": "615-577-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 W US HIGHWAY 90",
            "address_2": "SUITE 140",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553739",
            "telephone_number": "386-754-6671",
            "fax_number": "386-754-8673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMNI HOME HEALTH- HERNANDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-06-13",
        "status": "A",
        "authorized_official_last_name": "MCFADDIN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DIRECTOR OF LICENSING/ACCREDITATION",
        "authorized_official_telephone_number": "615-712-2250"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299991704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004157002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SunCrest OMNI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.