Extended Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

0000000224 Issued in TN

Legal business name

EXTENDED HEALTH CARE LLC

Practice address

7424 State Hwy 64 Ste 118
Bartlett, TN 38113-8937

Phone

(901) 881-0645

Fax

(901) 881-0647

NPI assigned

Jan 13, 2012

Organization subpart

No

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

Authorized official

Name

Debra M. Clark

Title

Vice Chairman of the Board of Dir

Phone

(901) 881-0645

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advantage Home Care Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Home health agency certification: CCN 447584

Legal name

EXTENDED HEALTH CARE LLC

Doing business as

ADVANTAGE HOME CARE

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 30, 2012

Last certification

Apr 24, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Dec 6, 2011 in TN

Enrollment address

7424 Hwy 64 Ste 118, Suite a
Bartlett, TN 38133

Listed as

Advantage Home CareCCN 447584

Ownership

Proprietary

Certified

Oct 30, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 5

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abdullah Arshad, MD

  • Internal Medicine Physician
  • Hayti, MO
  • NPI 1477660637
  NPD

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

{
    "created_epoch": "1326412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1972874402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 STATE HWY 64 STE 118",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381138937",
            "telephone_number": "901-881-0645",
            "fax_number": "901-881-0647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7424 STATE HWY 64 STE 118",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381138937",
            "telephone_number": "901-881-0645",
            "fax_number": "901-881-0647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDED HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-13",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "VICE CHAIRMAN OF THE BOARD OF DIR",
        "authorized_official_telephone_number": "901-881-0645"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "0000000224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H447584",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nichole Ashton Ervin, PT
• Elizabeth Laudelina Eshun
• Charity R Eskew, RN, FNP-C
• Barbara P Evangelisti, NP-C
• Excel Centers of America, LLC
• Extended Home Care TN, LLC
• Olufemi Folabi Fadahunsi, D.D.S.
• Christian S Fahey, MD
• Nicholas Fair
• Adeola Olubukola Faleye, DMD

• All providers in Bartlett, TN
• Home Health Agency in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.

Verify at the official NPI Registry.