NPIMap

Organization Active NPI

Mooresville Home Care Services, LLC

Doing business as Lake Norman Home Health

  • Home Health Agency
  • Mooresville, NC
National Provider Identifier
1942683503
Registry record updated Sep 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MOORESVILLE HOME CARE SERVICES, LLC
Doing business as
Lake Norman Home Health
Lake Norman Regional Home Care
Practice address
142 S. Cardigan Way
Ste D-1
Mooresville, NC 28117-8537
Phone
(704) 660-4480
Fax
(704) 662-3312
NPI assigned
Jul 1, 2015
Last updated
Sep 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2024

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

Authorized official

Name
Mr. Joshua Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

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

Addresses

Primary practice location

142 S. Cardigan Way
Ste D-1
Mooresville, NC 28117-8537

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1942683503MedicaidNC

Other names 2

  • Lake Norman Home Health Doing business as
  • Lake Norman Regional Home Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161013000234 NC Part A Provider - Home Health Agency 1052609773 Practice locations: Mooresville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942683503. Details of each certification follow.

Home health agency certification: CCN 347215

Legal name
MOORESVILLE HOME CARE SERVICES LLC
Doing business as
LAKE NORMAN HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 8, 1996
Last certification
May 2, 2015
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 23, 2014 in DE
Enrollment address
142 S Cardigan Way
Ste D-1
Mooresville, NC 28117-8536

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lake Norman Home HealthCCN 347215 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Feb 8, 1996
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
34D0910117Mooresville Home Care Services LLC142 Cardigan Way, Suite D-1, Mooresville, NC 28117Certificate of waiverDec 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Lake Norman Home Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

142 S Cardigan Way
Ste D1
Mooresville, NC 28117
Phone (704) 660-4480

Ownership & related parties

All disclosed owners & managing parties 12

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 OfficerCfo/Treasurer Feb 22, 2023
Casey Perkins Individual W-2 Managing EmployeeAdministrator / Dirctor of Nursing Jan 16, 2022
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2018 100%
Joshua Lee Proffitt Individual Corporate OfficerTreasurer Apr 30, 2018
Almost Family, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 31, 2016 100%
National Health Industries, Inc. Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Dec 31, 2016 80%
Afam Holding Co VI, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Apr 1, 2024 100%
Afam Sub I LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2024 20%
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025

Facilities with the same owner 111

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

View all 111

Practitioners & affiliated clinicians

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1942683503",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 S. CARDIGAN WAY",
            "address_2": "STE D-1",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178537",
            "telephone_number": "704-660-4480",
            "fax_number": "704-662-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORESVILLE HOME CARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1942683503",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Norman Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lake Norman Regional Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.