HARROGATE FAMILY & HEALTH CARE, INC.
NPI 1689831802, organization, Harrogate, TN, Family Medicine
- Listed on the KY Medicaid exclusion list since June 5, 2020.
- Medicaid still paid claims in 8 later months, $51,396 in total.
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| KY Medicaid exclusion list state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap) | Exact NPI, name verified | Jun 5, 2020 | still open | 8 | Jul 2020 | Feb 2021 | $51K | $190K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | HARROGATE FAMILY & HEALTH CARE, INC. |
| Type | Organization |
| Status | Active |
| NPI issued | May 16, 2008, last updated February 12, 2021 |
| Practice location | 169 WESTMORELAND ST LOWR LEVEL, Harrogate, TN 37752-8253, 423-869-0004 |
| Authorized official | DEBBIE POORE (Owner) |
| Specialties | Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X) Physician Assistant (363A00000X) Nurse Practitioner, Family (363LF0000X) Family Medicine (207Q00000X, primary) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| S5125 | Attendant care services per 15 minhistory of abuse | $349K | 45% | $2K | $2K (top 5% from $5K) | 50th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $198K | 26% | $38 | $44 (top 5% from $110) | too few months to rank | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $108K | 14% | $45 | $60 (top 5% from $133) | too few months to rank | |
| T1019 | Personal care services per 15 minhistory of abuse | $33K | 4% | $884 | $2K (top 5% from $4K) | too few months to rank | |
| 96372 | Injection of drug or substance under skin or into muscle | $19K | 2% | $12 | $12 (top 5% from $49) | too few months to rank | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $15K | 2% | $23 | $22 (top 5% from $33) | too few months to rank | |
| 90471 | Administration of vaccine | $7K | 1% | $12 | $10 (top 5% from $23) | too few months to rank | |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | $6K | 1% | $10 | $12 (top 5% from $18) | too few months to rank |
In this area
216 providers in TN carry an indicator in the public record, with $202.7M at stake between them. The most common is more hours than a day holds, on 139 of them, followed by part of a provider network on 42. 23 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | POPLAR AVENUE CLINIC PLLC Memphis, TN, ranked 54 | $1.5M |
|
| 1 | SANJEEV KUMAR Memphis, TN, ranked 75 | $707K |
|
| 1 | TRENT CROSS Oneida, TN, ranked 173 | $61K |
|
| 1 | OTYLIA PRIMARY CARE, LLC Memphis, TN, ranked 207 | $37K |
|
| 1 | DAVID SINCAVAGE Brentwood, TN, ranked 215 | $33K |
|
| 1 | ALEXANDER ALPEROVICH Jackson, TN, ranked 269 | $12K |
|
| 1 | RAMON AQUINO Clarksville, TN, ranked 357 | $3K |
|
| 1 | HORIZON CLINICIANS PLLC Sevierville, TN, ranked 381 | $1K |
|
Recent enforcement in TN
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.