NPIMap

Organization Active NPI

Medical Center Home Health, LLC

  • Home Health Agency
  • Jackson, TN
National Provider Identifier
1932355997
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MEDICAL CENTER HOME HEALTH, LLC
Practice address
1804 Highway 45 Byp Ste 430
Jackson, TN 38305-4436
Phone
(731) 984-2000
Fax
(731) 984-2079
NPI assigned
Aug 11, 2008
Last updated
Jul 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Executive Vice President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

1804 Highway 45 Byp Ste 430
Jackson, TN 38305-4436

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090218000209 TN Part A Provider - Home Health Agency 7810052255 Practice locations: Bolivar, TN; Jackson, TN; Milan, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932355997. Details of each certification follow.

Home health agency certification: CCN 447101

Legal name
MEDICAL CENTER HOME HEALTH, LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 2, 1975
Last certification
Oct 30, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jul 7, 2008 in TN
Enrollment address
1804 Highway 45 Byp
Ste 430
Jackson, TN 38305-4436

Care Compare: Home health agency

Medicare Care Compare
Listed as
Medical Center Home Health LLCCCN 447101 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Apr 2, 1975
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

103 S Lauderdale St
Bolivar, TN 38008
Phone (731) 658-9090

1804 Highway 45 Byp
Ste 430
Jackson, TN 38305
Phone (731) 984-2000

1148 S Main St
#B
Milan, TN 38358
Phone (731) 686-8061

300 Hospital Dr
Trenton, TN 38382
Phone (731) 855-4883

Ownership & related parties

All disclosed owners & managing parties 10

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 67%
Marcus Donavon Macip Individual Corporate OfficerCorporate Secretary Feb 22, 2023
Amanda Garcia Individual W-2 Managing EmployeeAdministrator/Director of Nursing Dec 19, 2022
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
Jackson Madison County General Hospital Organization, Jackson, TN Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2008 33%
Tennessee Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Oct 1, 2008 67%
Wendy S Daigle Individual Corporate DirectorDirector of Licensure & Reg Affairs Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Oct 1, 2008 67%
Operational/Managerial Control Oct 1, 2008
West Tennessee Homecare LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Oct 1, 2008 100%
Joshua Lee Proffitt Individual Corporate OfficerPresdient Dec 31, 2019

Owners & managing parties with NPI records 8

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

Facilities with the same owner 56

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

View all 56

Practitioners & affiliated clinicians

Affiliated clinicians 90

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

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1932355997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP STE 430",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054436",
            "telephone_number": "731-984-2000",
            "fax_number": "731-984-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CENTER HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.