Kccare Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

KCCARE HEALTH LLC

Practice address

10502 Fountain Lake Dr Apt 422
Stafford, TX 77477-3716

Phone

(281) 520-9413

Fax

(832) 747-9822

NPI assigned

May 4, 2023

Organization subpart

No

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

Authorized official

Name

Kingsley Onyejide

Title

Administrator

Phone

(281) 520-9413

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683158400000",
    "number": "1982393971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10502 FOUNTAIN LAKE DR APT 422",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773716",
            "telephone_number": "281-520-9413",
            "fax_number": "832-747-9822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10502 FOUNTAIN LAKE DR APT 422",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773716",
            "telephone_number": "281-520-9413",
            "fax_number": "832-747-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KCCARE HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A",
        "authorized_official_last_name": "ONYEJIDE",
        "authorized_official_first_name": "KINGSLEY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-520-9413"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Skylar Simone Kamp
• Lisa Heacock Karr
• Shumaila Kashan
• Roslyn Kavalam
• Olubunkanla Ojubayo Kayode, FNP
• Keeble Lovall
• Kristen Kell
• Joan Marie Kensey
• Kevin Monta Ruffin Sr
• Angela Khamsini

• Home Health Agency in Stafford, TX
• Providers in Stafford, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.