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Organization Active NPI

Professional Home Health Care Agency, Inc.

  • Home Health Agency
  • London, KY
National Provider Identifier
1912995127
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
150090 Issued in KY
Legal business name
PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Practice address
4934 S Laurel Rd
London, KY 40744-7985
Phone
(606) 864-0724
Fax
(606) 864-5256
NPI assigned
Oct 11, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mrs. Joyce Lewis
Title
Ceo
Phone
(606) 877-1135

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Affiliated clinicians 17

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Professional Home Health Care, IncCCN 187146
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Mar 22, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Medicare participation

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

Home health agency certification: CCN 187146

Medicare enrollment files
Legal name
PROFESSIONAL HOME HEALTH CARE AGENCY, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 22, 1989
Last certification
Jun 20, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Sep 2, 1977 in TN
Enrollment address
4934 South Laurel Road
London, KY 40744-7985
HHA Branch

All disclosed owners & managing parties 5

Medicare enrollment files

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

NameRoleSinceShare
Joyce Lewis Individual Corporate Officer Aug 20, 1991
Corporate Director Jan 28, 2010
Operational/Managerial Control Aug 20, 1991
William Cook Individual Corporate Officer Nov 13, 2002
Corporate Director Jan 28, 2010
Operational/Managerial Control Nov 13, 2002
Kathryn Darlene Litteral Individual Corporate Director Feb 23, 2026
Jimmy Lewis Individual Corporate Officer Jun 27, 1997
Corporate Director Jan 28, 2010
Operational/Managerial Control Jun 27, 1997
Jason Lewis Individual Corporate Director May 18, 2021

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20100225000324 KY Part a Provider - Home Health Agency 0244374460 Practice locations: Lexington, KY; Corbin, KY; Barbourville, KY; Lafollette, TN; London, KY

National Provider Directory

National Provider Directory

Locations

1957 S US Highway 25E
Barbourville, KY 40906
Phone (606) 302-5116

1829 S Main St
Corbin, KY 40701
Phone (606) 523-4455

1805 S Main St
Corbin, KY 40701
Phone (606) 258-1995

4934 S Laurel Rd
London, KY 40744
Phone (606) 864-0724

2221 Jacksboro Pike
Ste A9
La Follette, TN 37766
Phone (423) 562-6870

Specialties & licenses 6

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 42620021 KY
Home Health Agency 251E00000X 150090 KY Primary
Nursing Care Agency 251J00000X KY
Supports Brokerage Agency 251X00000X 90012964 KY
Early Intervention Provider Agency 252Y00000X 45343969 KY
Clinical Medical Laboratory 291U00000X KY

Addresses

NPPES NPI Registry

Primary practice location

4934 S Laurel Rd
London, KY 40744-7985

Mailing address

4934 S Laurel Rd
London, KY 40744-7985
Phone (606) 864-0724

Other identifiers 4

NPPES NPI Registry
IdentifierTypeStateIssuer
45343969OtherKYEPSDT
42620021OtherKYHCBW
34620039MedicaidKY
90012964OtherKYKMA DME

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 28, 2015.

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1912995127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4934 S LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407447985",
            "telephone_number": "606-864-0724",
            "fax_number": "606-864-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 S LAUREL RD",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407447985",
            "telephone_number": "606-864-0724",
            "fax_number": "606-864-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HOME HEALTH CARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "606-877-1135",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "KY",
            "license": "42620021",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "KY",
            "license": "150090",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": "KY",
            "license": "90012964",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "KY",
            "license": "45343969",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "KY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EPSDT",
            "identifier": "45343969",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HCBW",
            "identifier": "42620021",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34620039",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KMA DME",
            "identifier": "90012964",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.