NPIMap

Organization Active NPI

Dixie Home Rehab LLC

  • Home Health Agency
  • St George, UT
National Provider Identifier
1982772109
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
DIXIE HOME REHAB LLC
Practice address
393 E Riverside Dr
Suite 203
St George, UT 84790-7126
Phone
(435) 628-8347
Fax
(435) 628-3472
NPI assigned
Dec 4, 2006
Last updated
Aug 9, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
William S Hokanson
Title
Administrator
Phone
(435) 628-8347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

393 E Riverside Dr
Suite 203
St George, UT 84790-7126

Mailing address

393 E Riverside Dr
Suite 203
St George, UT 84790-7126
Phone (435) 628-8347

Other names 1

  • Dixie Home Rehab Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000107 UT Part A Provider - Home Health Agency 8628078565 Practice locations: St George, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982772109. Details of each certification follow.

Home health agency certification: CCN 467236

Legal name
DIXIE HOME REHAB LLC
Doing business as
DIXIE HOME REHAB
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 4, 2007
Last certification
Feb 6, 2019
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Feb 27, 2007 in UT
Enrollment address
352 E Riverside Dr
Ste B3B
St George, UT 84790-5808

Care Compare: Home health agency

Medicare Care Compare
Listed as
Dixie Home RehabCCN 467236 · All quality measures
Overall star rating
4.5 of 5
Ownership
Proprietary
Certified
Apr 4, 2007
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
46D1062109Dixie Home Rehab352 E Riverside Dr Ste B3B, St George, UT 84790Certificate of waiverDec 5, 2026

National Provider Directory

National Provider Directory

Locations

393 E Riverside Dr
Ste 203
St George, UT 84790
Phone (435) 628-8347

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Troy Mendenhall Individual 5% Or Greater Direct Ownership InterestOwner Dec 31, 2021 5%
William S Hokanson Individual 5% Or Greater Direct Ownership InterestOwner Dec 31, 2021 49%
Tina Syddell Individual W-2 Managing EmployeeDirector of Nursing Jul 1, 2018 100%
Redrock Health Partnership Organization, Pleasant Grove, UT 5% Or Greater Direct Ownership Interest Dec 31, 2021 41%
Mark Larsen Individual 5% Or Greater Direct Ownership InterestMember Mar 1, 2007 5%
Kari Coon Individual 5% Or Greater Indirect Ownership InterestMember Dec 31, 2021 41%
Melissa Murri Individual W-2 Managing EmployeeAdministrator Sep 11, 2017 100%

Practitioners & affiliated clinicians

Affiliated clinicians 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1982772109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 E RIVERSIDE DR",
            "address_2": "SUITE 203",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907126",
            "telephone_number": "435-628-8347",
            "fax_number": "435-628-3472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 E RIVERSIDE DR",
            "address_2": "SUITE 203",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907126",
            "telephone_number": "435-628-8347",
            "fax_number": "435-628-3472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE HOME REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "HOKANSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "435-628-8347"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dixie Home Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.