NPIMap

Organization Active NPI

St. Judes Specialty Home and Health Care Services, Inc

  • Home Health Agency
  • Laredo, TX
National Provider Identifier
1972742799
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ST. JUDES SPECIALTY HOME AND HEALTH CARE SERVICES, INC
Practice address
1220 Scott St
Laredo, TX 78040-6356
Phone
(956) 740-0106
Fax
(956) 727-1406
NPI assigned
Feb 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Authorized official

Name
Mrs. Patricia Guajardo, REGISTERED NURSE
Title
President
Phone
(956) 740-0106

Specialties & licenses 1

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

Addresses

Primary practice location

1220 Scott St
Laredo, TX 78040-6356

Mailing address

1220 Scott St
Laredo, TX 78040-6356
Phone (956) 740-0106

Other identifiers 1

IdentifierTypeStateIssuer
251E00000XOtherTXPTAN NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000292 TX Part A Provider - Home Health Agency 1355495680 Practice locations: Laredo, TX

Home health agency certification: CCN 747388

Legal name
ST. JUDES SPECIALTY HOME AND HEALTH CARE SERVICES, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 8, 2010
Last certification
Apr 11, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Feb 4, 2009 in FL
Enrollment address
1220 Scott St
Laredo, TX 78040-6356

Care Compare: Home health agency

Medicare Care Compare
Listed as
St. Jude'S Specialty Home and Health Care Services, Inc.CCN 747388
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 8, 2010
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
45D1107337St Judes Specialty Home and Health1220 Scott St, Laredo, TX 78040Certificate of waiverNov 2, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jose Guajardo Individual 5% Or Greater Direct Ownership InterestBoard of Directors Feb 4, 2009 33%
Corporate OfficerVP Feb 4, 2009 33%
Corporate Director Apr 30, 2003
W-2 Managing EmployeeVP Feb 4, 2009 33%
Ana C Lorenzo Individual Operational/Managerial ControlAlt Admin Aug 25, 2014
Maria Guajardo Individual 5% Or Greater Direct Ownership InterestBoard of Directors Feb 4, 2009 33%
Corporate OfficerCfo Feb 4, 2009 33%
Corporate Director May 9, 2009
Patricia Guajardo Individual 5% Or Greater Direct Ownership InterestPresident/Administrator Feb 4, 2009 34%
Corporate OfficerAdmin/Pres/Board Mem Feb 4, 2009 34%
Corporate DirectorAdmin/Pres/ Feb 4, 2009 34%
W-2 Managing EmployeePresident/Administrator Feb 4, 2009 25%

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1972742799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 SCOTT ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780406356",
            "telephone_number": "956-740-0106",
            "fax_number": "956-727-1406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 SCOTT ST",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780406356",
            "telephone_number": "956-740-0106",
            "fax_number": "956-727-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JUDES SPECIALTY HOME AND HEALTH CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "GUAJARDO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-740-0106",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN NUMBER",
            "identifier": "251E00000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.