NPIMap

Organization Active NPI

Cedar Creek Home Health Care Agency, LLC

Doing business as Deaconess HomeCare

  • Home Health Agency
  • Mount Juliet, TN
National Provider Identifier
1902897432
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
0282 Issued in TN
Legal business name
CEDAR CREEK HOME HEALTH CARE AGENCY, LLC
Doing business as
Deaconess HomeCare
Home Care Solutions
Practice address
1010 Pleasant Grove PL Ste 200
Mt Juliet, TN 37122-4457
Phone
(615) 453-8550
Fax
(615) 453-8584
NPI assigned
Nov 3, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 0282 TN Primary

Addresses

Primary practice location

1010 Pleasant Grove PL Ste 200
Mt Juliet, TN 37122-4457

Mailing address

1010 Pleasant Grove PL Ste 200
Mt Juliet, TN 37122-4457
Phone (615) 453-8550

Other practice location 1

2527 Highway 111 N Ste A
Cookeville, TN 38506-8985
Phone (931) 520-0090

Other identifiers 1

IdentifierTypeStateIssuer
0447138MedicaidTN

Other names 2

  • Deaconess HomeCare Doing business as
  • Home Care Solutions Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080123000045 TN Part A Provider - Home Health Agency 6800977364 Practice locations: Cookeville, TN; Mt Juliet, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902897432. Details of each certification follow.

Home health agency certification: CCN 447138

Legal name
CEDAR CREEK HOME HEALTH CARE AGENCY, LLC
Doing business as
DEACONESS HOMECARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 18, 1978
Last certification
Nov 8, 2017
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jun 30, 1988 in TN
Enrollment address
1010 Pleasant Grove PL
Ste 200
Mt Juliet, TN 37122-4457

Care Compare: Home health agency

Medicare Care Compare
Listed as
Deaconess Homecare 1CCN 447138 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 18, 1978
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
44D0703585Cedar Creek Home Health Care Agency LLC1010 Pleasant Grove Place, Suite 200, Mount Juliet, TN 37122Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

2527 Highway 111 N
Ste A
Cookeville, TN 38506
Phone (931) 520-0090

1010 Pleasant Grove Pl
Ste 200
Mt Juliet, TN 37122
Phone (615) 453-8550

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
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerCorporate Secretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
Elk Valley Professional Affiliates Inc Organization, Lafayette, LA For-profit 5% Or Greater Direct Ownership Interest Apr 1, 2014 100%
Tennessee Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2014 100%
Dorothy Smith Individual W-2 Managing EmployeeAdministrator / Director of Nursing Mar 13, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2014 100%
Operational/Managerial Control Apr 1, 2014
Joshua Lee Proffitt Individual Corporate OfficerPresident Apr 1, 2014

Owners & managing parties with NPI records 1

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

Facilities with the same owner 46

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

View all 46

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1902897432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 PLEASANT GROVE PL STE 200",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224457",
            "telephone_number": "615-453-8550",
            "fax_number": "615-453-8584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 PLEASANT GROVE PL STE 200",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224457",
            "telephone_number": "615-453-8550",
            "fax_number": "615-453-8584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2527 Highway 111 N Ste A",
            "address_purpose": "LOCATION",
            "city": "Cookeville",
            "state": "TN",
            "postal_code": "385068985",
            "country_code": "US",
            "telephone_number": "931-520-0090",
            "fax_number": "931-520-0101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CEDAR CREEK HOME HEALTH CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "0282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0447138",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Deaconess HomeCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Care Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Juliet, TN

Sources for this page

Verify at the official NPI Registry.