PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH LLC (NPI# 1649662495) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649662495 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH LLC |
| Practice Address |
3640 W Waco Dr Waco TX 76710 |
| Practice Telephone | 2543078607 |
| Practice Fax Number | 2547652501 |
| Mailing Telephone | 2543078607 |
| Mailing Fax Number | 2547652501 |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2017-10-20 |
| Authorized Official Name | NATASHA JAMES (ADMINISTRATOR) |
| Authorized Official Telephone | 2543078607 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
3640 W WACO DR |
| City | WACO |
| State | TX |
| Zip Code | 76710 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811460876 | Makeshia Smith | Registered Nurse | 3640 W Waco Dr, Waco, TX 76710-5345 | 2019-01-02 |
| 1851871248 | Sherryl Finch | Home Health | 3640 W Waco Dr, Waco, TX 76710-5345 | 2018-08-15 |
| 1902383326 | Natasha James | Home Health | 3640 W Waco Dr, Waco, TX 76710-5345 | 2018-07-27 |
| 1275010696 | Tyler Martin | Home Health | 3640 W Waco Dr, Waco, TX 76710-5345 | 2018-07-27 |
| 1356828354 | Sunny Day Deeds | Registered Nurse | 3640 W Waco Dr, Waco, TX 76710-5345 | 2018-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740741156 | Jessica Cook-lindsay | Physical Therapist | 2121 W Hwy 6, Waco, Waco, TX 76710 | 2019-03-28 |
| 1306354824 | Paula A Huffhines | Technician, Other | 115 S 25th, Waco, TX 76710 | 2018-01-18 |
| 1982154639 | Nha Do | Pharmacist | 1301 Wood Acres, Waco, TX 76710 | 2016-10-06 |
| 1881008795 | Soumava Sen, Dds, P.C. | Dentist | 4215 Franklin Ave, Ste. 300, Waco, TX 76710 | 2014-06-18 |
| 1053742221 | Dustin Dwain Kelm | Physical Therapist | 5400 Laurel Dr., Waco, TX 76710 | 2013-12-12 |
| 1881038776 | Penelope Diane Lane | Counselor | 7524 Bosque, Waco, TX 76710 | 2013-04-22 |
| 1538400627 | Erik Alexander Pernes Caluscusao | Physical Therapist | 415 Owen Ln Apt 911, Waco, TX 76710 | 2013-03-14 |
| 1447509039 | Sheree L Mach | Occupational Therapist | 5400 Laurel Lake Dr., Waco, TX 76710 | 2012-08-29 |
| 1568738425 | Ramanathan Anandaraman | Internal Medicine | 2608 Skyline Drive, Waco, TX 76710 | 2012-03-26 |
| 1669743886 | Staci Marie Gohring | Speech-Language Pathologist | 6701 Sanger Avenue, Waco, TX 76710 | 2012-01-19 |
| Find all providers in zip 76710 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750861142 | Kiffany Gaines | Home Health | 6418 May Dr, Waco, TX 76710-5648 | 2018-08-15 |
| 1831679232 | Ruth Graham | Home Health | 500 Preston St, Waco, TX 76704-2230 | 2018-08-15 |
| 1689153272 | Beatrice Guerrero | Home Health | 728 Greer St, Waco, TX 76710-4628 | 2018-08-14 |
| 1306209978 | Kdmedlink Services, LLC | Home Health | 2804 Chimney Hill Dr, Waco, TX 76708-2354 | 2016-04-01 |
| 1346581071 | Pf Development 17, LLC | Home Health | 5400 Bosque Blvd, Suite 260, Waco, TX 76710-4482 | 2013-03-05 |
| 1104115047 | Accentcare Inc | Home Health | 7503 Bosque Blvd, Waco, TX 76712-3713 | 2011-03-31 |
| 1184853145 | Bethany Hh of Waco LLC | Home Health | 329 W Hwy 6, Suite B, Waco, TX 76710-5590 | 2009-07-10 |
| 1831312859 | Texas Home Health Skilled Services, Lp | Home Health | 8300 Central Park Dr, Suite A, Waco, TX 76712-6667 | 2007-04-10 |
| 1841327848 | Abc Health Care Inc | Home Health | 600 Austin Ave, Suite 27, Waco, TX 76701-2018 | 2007-02-27 |
| 1851459655 | Hoffmeyer Tate Inc | Home Health | 6312 Cobbs Dr, Waco, TX 76710-2535 | 2006-12-05 |
| Find all providers in WACO | ||||
Please comment or provide details below to improve the information on PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.