NPIMap

Organization Active NPI

LHCG Xlvi, LLC

Doing business as Lifeline Home Health

  • Home Health Agency
  • Tompkinsville, KY
National Provider Identifier
1972933323
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
LHCG XLVI, LLC
Doing business as
Lifeline Home Health
Practice address
710 N Main St
Tompkinsville, KY 42167-1130
Phone
(270) 487-5905
Fax
(270) 487-6369
NPI assigned
Nov 22, 2013
Last updated
Jan 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Executive Vice President
Phone
(337) 233-1307

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X
Rural Health Clinic/Center 261QR1300X
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X

Addresses

Primary practice location

710 N Main St
Tompkinsville, KY 42167-1130

Mailing address

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

Other names 1

  • Lifeline Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140227000471 KY Part A Provider - Home Health Agency 1052541653 Practice locations: Tompkinville, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972933323. Details of each certification follow.

Home health agency certification: CCN 187130

Legal name
LHCG XLVI, LLC
Doing business as
LIFELINE HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 26, 1985
Last certification
Feb 27, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Apr 11, 2013 in KY
Enrollment address
710 North Main Street
Tompkinville, KY 42167-1130

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lifeline Home HealthCCN 187130 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Dec 26, 1985
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
18D2071287LHCG Xlvi, LLC Dba Lifeline Home Health710 North Main Street, Tompkinsville, KY 42167Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
LHCG Xlvi2 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

431 Capp Harlan Rd
Tompkinsville, KY 42167
Phone (270) 487-5905

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
Kentucky Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Feb 1, 2014 100%
Amanda Dawn Isenberg Individual W-2 Managing EmployeeAdministrator/Director of Nursin Dec 21, 2015
Operational/Managerial ControlAdministrator/Director of Nursin Dec 21, 2015
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Feb 1, 2014 100%
Operational/Managerial Control Feb 1, 2014
Joshua Lee Proffitt Individual Corporate OfficerPresident / Cfo Dec 31, 2019

Facilities with the same owner 9

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

Practitioners & affiliated clinicians

Affiliated clinicians 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1972933323",
    "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": "710 N MAIN ST",
            "city": "TOMPKINSVILLE",
            "state": "KY",
            "postal_code": "421671130",
            "telephone_number": "270-487-5905",
            "fax_number": "270-487-6369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG XLVI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifeline Home Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lifeline Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tompkinsville, KY

Sources for this page

Verify at the official NPI Registry.