Active NPI
Nathan Obiorah Ogbatue
- Home Health Agency
- Riverside, CA
National Provider Identifier
1942544812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 11860 Magnolia Avenue, Suite J,
Riverside, CA 92503-4911 - Phone
- (951) 352-2300
- Fax
- (951) 352-2333
- NPI assigned
- Nov 16, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
11860 Magnolia Avenue, Suite J,
Riverside, CA 92503-4911
Mailing address
11860 Magnolia Avenue, Suite J,
Riverside, CA 92503-4911
Phone (951) 352-2300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120919000174 | CA | Part A Provider - Home Health Agency | 4688646227 |
Home health agency certification: CCN 059615
- Legal name
- NATHAN O. OGBATUE
- Doing business as
- CALIFORNIA HOME HEALTH AGENCY
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Jun 12, 2014
- Last certification
- Aug 11, 2020
- Ownership / control type
- Proprietary
- Organization structure
- Sole Proprietor
- Enrollment address
- 11860 Magnolia Ave J
Riverside, CA 92503-4911
Care Compare: Home health agency
Medicare Care Compare- Listed as
- California Home Health Agency
- Ownership
- Proprietary
- Certified
- Jun 12, 2014
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nathan O Ogbatue | Home Health | Past | Accepting new patients |
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nathan O Ogbatue | 5% Or Greater Direct Ownership Interest | Jan 22, 2013 | 100% |
| W-2 Managing Employee | Mar 25, 2004 | 100% | |
| Operational/Managerial Control | Mar 25, 2004 | 100% | |
| Agnes C Ogbatue | W-2 Managing Employee | Mar 25, 2004 | 50% |
| Operational/Managerial Control | Mar 25, 2004 |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Riverside, CA
- NPI 1922477975
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1942544812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11860 MAGNOLIA AVENUE, SUITE J,",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925034911",
"telephone_number": "951-352-2300",
"fax_number": "951-352-2333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11860 MAGNOLIA AVENUE, SUITE J,",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925034911",
"telephone_number": "951-352-2300",
"fax_number": "951-352-2333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OGBATUE",
"first_name": "NATHAN",
"middle_name": "OBIORAH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-11-16",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; 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.