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SOUTHPORT HEALTHCARE LLC
NPI 1285352500
Home Health in Kenosha, WI

Active since August 22, 2022CLIA 52D0389393 · Waiver
600 52ND ST STE 300, KENOSHA, WI 53140(262) 656-8400 Get Directions Write a Review

NPPES record last updated: December 19, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 19, 2025, Jan 7, 2025, Oct 20, 2022 and 1 more (4 updates tracked since 2022).

About Southport Healthcare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHPORT HEALTHCARE LLC (NPI 1285352500), doing business as Kenosha Visiting Nurse Association, is a healthcare organization registered as a home health in Kenosha, Wisconsin and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through June 28, 2027 and lists Amber L Tueller, Secretary, as its authorized official.

NPPES Registry Identity

NPI1285352500
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameSOUTHPORT HEALTHCARE LLC
Location Address600 52ND ST STE 300Kenosha, WI 53140-3423
Mailing Address600 52nd St Ste 300Kenosha, WI 53140-3423 · (262) 656-8400
Phone(262) 656-8400
Organization SubpartNo
Authorized OfficialAmber L TuellerSecretary · (208) 207-2726
Enumeration DateAugust 22, 2022
Last NPPES UpdateDecember 19, 20254 updates tracked since enumeration
NPPES CertifiedDecember 19, 2025
✔ NPI 1285352500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
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.
600 52ND ST STE 300, Kenosha, WI 53140
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Other Names 2

Doing Business AsKenosha Visiting Nurse Association
Doing Business AsPreceptor Home Health South

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0389393

Southport Healthcare LLC Dba Preceptor Home Health South · Kenosha, WI
Active · expires Jun 28, 2027
CLIA Number52D0389393
Laboratory TypeHome Health Agency
Certificate Effective DateJune 29, 2025
Certificate Expiration DateJune 28, 2027
Laboratory DirectorKellie Raper
Laboratory Phone(262) 656-8400
Laboratory LocationSouthport Healthcare LLC Dba Preceptor Home Health South600 52nd St, Suite 300, Kenosha, WI 53140
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SOUTHPORT HEALTHCARE LLC
Hospice Care, Community Based
600 52ND ST STE 300
KENOSHA, WI 53140
Kenosha County (262) 656-8400
SOUTHPORT HEALTHCARE LLC
Clinic/Center (Community Health)
600 52ND ST STE 300
KENOSHA, WI 53140
Kenosha County (262) 656-8400
VISITING NURSE COMMUNITY CARE, INC.
Clinic/Center (Rehabilitation)
600 52ND ST STE 300
KENOSHA, WI 53140
Kenosha County (262) 656-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southport Healthcare LLC's NPI number?

The NPI number for Southport Healthcare LLC is 1285352500. It was assigned to this organization in the NPPES registry on August 22, 2022. The provider is doing business as Kenosha Visiting Nurse Association and Preceptor Home Health South.

Where is Southport Healthcare LLC located?

Southport Healthcare LLC is located at 600 52nd St Ste 300, Kenosha, WI 53140. The listed phone number is (262) 656-8400.

What is Southport Healthcare LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Southport Healthcare LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0389393) is associated with this NPI, valid through June 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southport Healthcare LLC accept?

Health plans from UnitedHealthcare list Southport Healthcare LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southport Healthcare LLC was last updated on December 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.