NPIMap

Organization Active NPI

Golden Home Care L.L.C.

  • Home Health Agency
  • Las Vegas, NV
National Provider Identifier
1992275184
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
GOLDEN HOME CARE L.L.C.
Practice address
3530 E Flamingo Rd Ste 101
Las Vegas, NV 89121-5091
Phone
(702) 462-2660
Fax
(775) 571-0502
NPI assigned
Nov 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Authorized official

Name
Ms. Nildee Fernandez, RN
Title
Administrator
Phone
(786) 879-3384

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3530 E Flamingo Rd Ste 101
Las Vegas, NV 89121-5091

Mailing address

3530 E Flamingo Rd Ste 101
Las Vegas, NV 89121-5091
Phone (702) 462-2660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028001623 CA Part A Provider - Home Health Agency 4981014255 Practice locations: Las Vegas, NV

Home health agency certification: CCN 297303

Legal name
GOLDEN HOME CARE LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 10, 2021
Last certification
Jun 10, 2021
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Sep 22, 2018 in NV
Enrollment address
3530 E Flamingo Rd
Ste 101
Las Vegas, NV 89121-5091

Care Compare: Home health agency

Medicare Care Compare
Listed as
Golden Home Care LLCCCN 297303
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 10, 2021
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide

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
29D2197212Golden Home Care LLC3530 E Flamingo Rd Ste 101, Las Vegas, NV 89121Certificate of waiverOct 21, 2026

National Provider Directory

National Provider Directory

Locations

3530 E Flamingo Rd
Ste 101
Las Vegas, NV 89121
Phone (702) 898-5700

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Nildee Fernandez Individual 5% Or Greater Direct Ownership Interest Sep 22, 2018 33.3%
Corporate OfficerCompany Secretary, Board Member Sep 22, 2018 33.3%
Corporate Director Sep 22, 2018 33.3%
W-2 Managing EmployeeCompany Secretary, Board Member Sep 22, 2018 33.3%
Operational/Managerial ControlCompany Secretary, Board Member Sep 22, 2018 33.3%
Yasmary Rodriguez Fidalgo Individual 5% Or Greater Direct Ownership Interest Sep 22, 2018 33.3%
Corporate OfficerChief Finance Officer, Board Mem Sep 22, 2018 33.3%
Corporate DirectorChief Finance Officer, Board Mem Sep 22, 2018 33.3%
W-2 Managing EmployeeChief Finance Officer, Board Mem Sep 22, 2018 33.3%
Operational/Managerial ControlChief Finance Officer, Board Mem Sep 22, 2018 33.3%
Javier Hernandez Diaz Individual 5% Or Greater Direct Ownership Interest Sep 22, 2018 33.3%
Corporate OfficerChief Executive Officer, Board M Sep 22, 2018 33.3%
Corporate DirectorChief Executive Officer, Board M Sep 22, 2018 33.3%
W-2 Managing EmployeeChief Executive Officer, Board M Sep 22, 2018 33.3%
Operational/Managerial ControlChief Executive Officer, Board M Sep 22, 2018 33.3%

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 9

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

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1992275184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3530 E FLAMINGO RD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215091",
            "telephone_number": "702-462-2660",
            "fax_number": "775-571-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 E FLAMINGO RD STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215091",
            "telephone_number": "702-462-2660",
            "fax_number": "775-571-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN HOME CARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "NILDEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-879-3384",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.