NPIMap

Organization Active NPI

LHCG XL, LLC

Doing business as Georgia Home Health

  • Home Health Agency
  • Atlanta, GA
National Provider Identifier
1962847053
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG XL, LLC
Doing business as
Georgia Home Health
Practice address
2000 Riveredge Parkway
Suite 925
Atlanta, GA 30328-4673
Phone
(770) 688-1000
Fax
(770) 698-9677
NPI assigned
May 3, 2013
Last updated
Dec 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Authorized official

Name
Donald D Stelly
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

2000 Riveredge Parkway
Suite 925
Atlanta, GA 30328-4673

Mailing address

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

Other names 1

  • Georgia Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130806000039 GA Part A Provider - Home Health Agency 1153563051 Practice locations: Altanta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962847053. Details of each certification follow.

Home health agency certification: CCN 117096

Legal name
LHCG XL ,LLC
Doing business as
GEORGIA HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 7, 1991
Last certification
May 9, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Enrollment address
2000 Riveredge Parkway
Suite 925
Altanta, GA 30328-4673

Care Compare: Home health agency

Medicare Care Compare
Listed as
Georgia Home HealthCCN 117096 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jun 7, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, 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
11D0873221LHCG XL, LLC2000 Riveredge Parkway, Suite 925, Atlanta, GA 30328Certificate of waiverJul 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Georgia 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

2000 Riveredge Pkwy
Ste 925
Sandy Springs, GA 30328
Phone (770) 688-1000

5500 Interstate North Pkwy
Ste 400
Sandy Springs, GA 30328
Phone (678) 201-0252

Ownership & related parties

All disclosed owners & managing parties 8

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 OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCfo/Treasurer Feb 22, 2023
Georgia Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Jul 1, 2013 100%
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2013 100%
Operational/Managerial Control Jul 1, 2013
Joshua Lee Proffitt Individual Corporate OfficerPresident Jul 1, 2013
Freedricka Denton Individual W-2 Managing EmployeeAdministrator Feb 26, 2024

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1962847053",
    "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": "2000 RIVEREDGE PARKWAY",
            "address_2": "SUITE 925",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284673",
            "telephone_number": "770-688-1000",
            "fax_number": "770-698-9677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG XL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgia Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.