Adelaide Home Health, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

010017 Issued in TX

Legal business name

ADELAIDE HOME HEALTH, LLC

Practice address

2000 N Central Expy
Suite # 120
Plano, TX 75074-8801

Phone

(972) 424-4024

Fax

(972) 424-2244

NPI assigned

Mar 31, 2006

Last updated

Dec 14, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Johnson Jacob

Title

Administrator

Phone

(972) 424-4024

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922069541. Details of each certification follow.

• CCN 677854 Home health agency · Active · Details

Home health agency certification: CCN 677854

Legal name

ADELAIDE HOME HEALTH, LLC

Doing business as

ADELAIDE HOME HEALTH LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 17, 2006

Last certification

Oct 13, 2020

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Apr 27, 2005 in TX

Enrollment address

2000 N Central Expy
Ste 120
Plano, TX 75074-5486

Listed as

Adelaide Home Health LLCCCN 677854 · All quality measures

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Mar 17, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

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

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1922069541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N CENTRAL EXPY",
            "address_2": "SUITE # 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748801",
            "telephone_number": "972-424-4024",
            "fax_number": "972-424-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N CENTRAL EXPY",
            "address_2": "SUITE # 120",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748801",
            "telephone_number": "972-424-4024",
            "fax_number": "972-424-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADELAIDE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "JOHNSON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-424-4024",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "010017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Plano, TX
• Providers in Plano, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2018; 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.

Verify at the official NPI Registry.