NPIMap

Organization Active NPI

South Carolina in-Home Partner-I, LLC

Doing business as Providence Home Health

  • Home Health Agency
  • Columbia, SC
National Provider Identifier
1972001956
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
SOUTH CAROLINA IN-HOME PARTNER-I, LLC
Doing business as
Providence Home Health
Practice address
140 Stoneridge Dr Ste 520
Columbia, SC 29210-8258
Phone
(803) 343-5100
Fax
(803) 758-4001
NPI assigned
Jan 25, 2018
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

140 Stoneridge Dr Ste 520
Columbia, SC 29210-8258

Mailing address

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

Other names 1

  • Providence Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180411000168 SC Part A Provider - Home Health Agency 3375806060 Practice locations: Columbia, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972001956. Details of each certification follow.

Home health agency certification: CCN 427109

Legal name
SOUTH CAROLINA IN-HOME PARTNER-I LLC
Doing business as
PROVIDENCE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 8, 1997
Last certification
Jun 29, 2018
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Jan 11, 2018 in SC
Enrollment address
140 Stoneridge Dr
Ste 520
Columbia, SC 29210-8258

Care Compare: Home health agency

Medicare Care Compare
Listed as
Providence Home HealthCCN 427109 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
May 8, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Physical therapy, Speech pathology

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
42D0877062South Carolina in-Home Partner-I, LLC140 Stoneridge Dr, Suite 520, Columbia, SC 29210Certificate of waiverSep 27, 2027

National Provider Directory

National Provider Directory

Locations

140 Stoneridge Dr
Ste 520
Columbia, SC 29210
Phone (803) 343-5100

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 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
South Carolina in-Home Partner-I LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Mar 1, 2018 100%
South Carolina Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
William Ervin Individual W-2 Managing EmployeeAdministrator Feb 9, 2022
Wendy S Daigle Individual Corporate OfficerDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Operational/Managerial Control Mar 1, 2018
Joshua Lee Proffitt Individual Corporate OfficerPresident Apr 1, 2022
Amy Cormier Individual Corporate DirectorDirector, Managed Care Network May 1, 2025

Change-of-ownership history 1

DateEventCounterparty
Mar 1, 2018 Change of OwnershipThis provider was the buyer South Carolina HomecareCCN 427109, SC, NPI 1326385055

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1516838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1972001956",
    "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": "140 STONERIDGE DR STE 520",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108258",
            "telephone_number": "803-343-5100",
            "fax_number": "803-758-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CAROLINA IN-HOME PARTNER-I, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-25",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.