PROVIDENCE HOME HEALTH, LLC (NPI# 1205435567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205435567 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE HOME HEALTH, LLC |
| Practice Address |
5568 General Washington Dr Ste A201 Alexandria VA 22312-2465 |
| Practice Telephone | 5712956991 |
| Practice Fax Number | 8778526352 |
| Mailing Telephone | 7037052112 |
| Mailing Fax Number | 8778526352 |
| Enumeration Date | 2020-10-19 |
| Last Update Date | 2020-10-19 |
| Authorized Official Name | MS. CYNTHIA A BARDWELL (PRESIDENT) |
| Authorized Official Telephone | 7037052112 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 164W00000X | Licensed Practical Nurse | Nursing Service Providers | ||
| N | 171M00000X | Case Manager/Care Coordinator | Other Service Providers | ||
| N | 224Z00000X | Occupational Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225200000X | Physical Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
Speech, Language and Hearing Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 3747A0650X |
Technician Specialization: Attendant Care Provider |
Nursing Service Related Providers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| Y | 163W00000X | Registered Nurse | Nursing Service Providers |
| Street Address |
5568 GENERAL WASHINGTON DR STE A201 |
| City | ALEXANDRIA |
| State | VA |
| Zip Code | 22312-2465 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959827 | Stella Nancy Morgan-bendu | Licensed Practical Nurse | 5568 General Washington Dr Ste A201, Alexandria, VA 22312-2465 | 2020-10-16 |
| 1891393252 | Victor Sepha Morgan | Registered Nurse | 5568 General Washington Dr Ste A201, Alexandria, VA 22312-2465 | 2020-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639710429 | Lake Barcroft Dental Group, PC | Dentist | 6464 A1 Lincolnia Rd, Alexandria, VA 22312 | 2019-10-02 |
| 1538684790 | Feras Ibrahim Hawari | Internal Medicine | 4714 Minor Cir, Alexandria, VA 22312 | 2017-08-09 |
| 1285081984 | Nicole Heidbreder Lehr | Behavioral Analyst | 5400 Shawnee Rd Ste 208, Alexandria, VA 22312 | 2016-05-23 |
| 1922486372 | Fassity Home Care LLC | Home Health | 6601 Little River Turn Pike, Suit 210, Alexandria, VA 22312 | 2015-05-18 |
| 1730582107 | Prospect Homecare Agency | Home Health | 5568 General Washington Drive, Suite A 203, Alexandria, VA 22312 | 2014-09-30 |
| 1396926952 | Fairfax Home Health Care, Inc. | Home Health | 4810 Beauregard Street, Suite G4, Alexandria, VA 22312 | 2007-11-23 |
| 1114047768 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 5590 General Washington Drive, Alexandria, VA 22312 | 2007-03-29 |
| 1548339682 | Virginia Pathology Svcs PC | Pathology | 6121 Lincolnia Rd, Suite 108, Alexandria, VA 22312 | 2006-11-06 |
| 1336150531 | Joel Carlton Goldstein | Dentist | 4605 B Pinecrest Office Park Dr, Alexandria, VA 22312 | 2006-08-11 |
| 1619915923 | Jong K Lee | Family Medicine | 4605 A Pinecrest Office, Alexandria, VA 22312 | 2006-06-02 |
| Find all providers in zip 22312 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401058 | Katherine Heatherington Endres | Registered Nurse | 6123 Beech Tree Dr, Alexandria, VA 22310-2240 | 2020-03-05 |
| 1073147518 | Jennifer Marie Downey | Registered Nurse | 802 Manor Rd Apt 302, Alexandria, VA 22305-1126 | 2020-02-24 |
| 1003450412 | Felicia Aboagye | Registered Nurse | Gartlan Center, 8119 Holland Road, Alexandria, VA 22306 | 2019-10-30 |
| 1033766357 | Robel Tajanlangit Dabandan | Registered Nurse | 1543b N Van Dorn St, Alexandria, VA 22304-1922 | 2019-08-21 |
| 1992359889 | Faustina Darko Sarpong | Registered Nurse | Alexandria Residential Treatment Center, 2355 Mill Rd, Alexandria, VA 22314 | 2019-07-29 |
| 1912481318 | Gearldean Lighten | Registered Nurse | 727 Everett Loop Apt B, Alexandria, LA 71302-5500 | 2018-09-20 |
| 1326565359 | Sheryl Ann Truman | Registered Nurse | 3224 Madonna Drive, Alexandria, LA 71301 | 2017-08-30 |
| 1467993139 | Jessica Superales | Registered Nurse | 2000 N Beauregard St Ste 360, Alexandria, VA 22311-1751 | 2017-03-15 |
| 1760929764 | Thecla Nkemateh | Registered Nurse | 4875 Eisenhower Ave Ste 220, Alexandria, VA 22304-4833 | 2017-01-27 |
| 1528511458 | Ngozi Adom | Registered Nurse | 1204 S Washington St, Apt.403, Alexandria, VA 22314-4405 | 2016-07-27 |
| Find all providers in ALEXANDRIA | ||||
| City | ALEXANDRIA |
| Zip Code | 22312 |
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| 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.