Premier One Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HHA7720 Issued in AZ

Legal business name

PREMIER ONE HOME CARE LLC

Practice address

931 E Southern Ave Ste 107
Mesa, AZ 85204-5036

Phone

(480) 773-6837

Fax

(480) 773-6854

NPI assigned

Oct 12, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Narinder S MudharNPI 1336590082

Title

Administrator/Cfo

Phone

(480) 773-6837

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Home health agency certification: CCN 037478

Legal name

PREMIER ONE HOME CARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Apr 13, 2018

Last certification

Jun 18, 2019

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Mar 28, 2016 in AZ

Enrollment address

931 E Southern Ave
Ste 110
Mesa, AZ 85204-5036
HHA Branch

Listed as

Premier One Home Care, LLCCCN 037478

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Apr 13, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, 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 2

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.

• Narinder Mudhar

  • Home Health Agency
  • Mesa, AZ
  • NPI 1336590082
  NPD Authorized official

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1982154076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "931 E SOUTHERN AVE STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045036",
            "telephone_number": "480-773-6837",
            "fax_number": "480-773-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 E SOUTHERN AVE STE 107",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852045036",
            "telephone_number": "480-773-6837",
            "fax_number": "480-773-6854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER ONE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "MUDHAR",
        "authorized_official_first_name": "NARINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR/CFO",
        "authorized_official_telephone_number": "480-773-6837",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "AZ",
            "license": "HHA7720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.