SUPREME HEALTH CARE SERVICES (NPI# 1386838571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386838571 |
| Entity Type | Organization |
| Organization Name | SUPREME HEALTH CARE SERVICES |
| Practice Address |
3300 Tyre Neck Road Suite F Portsmouth VA 23703-3319 |
| Practice Telephone | 7573930327 |
| Practice Fax Number | 7573930328 |
| Mailing Telephone | 7573930327 |
| Mailing Fax Number | 7573930328 |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2012-08-03 |
| Authorized Official Name | MR. JOHN OMONKHUALE MADOJEMU (PROGRAM DIRECTOR) |
| Authorized Official Telephone | 7573930327 |
| Authorized Official Credential | MSM, PHD (C) |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 251F00000X | Home Infusion | Agencies | ||
| N | 251G00000X | Hospice Care, Community Based | Agencies | ||
| N | 251J00000X | Nursing Care | Agencies | ||
| N | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 311Z00000X | Custodial Care Facility | Nursing & Custodial Care Facilities | ||
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| N | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities | ||
| N | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities | ||
| N | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities | ||
| N | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
Respite Care Facility | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| N | 385HR2065X |
Respite Care Specialization: Respite Care, Physical Disabilities, Child |
Respite Care Facility | ||
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
3300 TYRE NECK ROAD SUITE F |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23703-3319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174037444 | Kelly Foster | Massage Therapist | 3108 Tyre Neck Rd Ste D, Portsmouth, VA 23703 | 2017-11-25 |
| 1578072104 | Katherine Armstrong Wise | Behavior Technician | 3120 Verne Ave, Portsmouth, VA 23703 | 2017-09-27 |
| 1891223913 | Ashley Rebecca Anderson | Dentist | 5915 High Street W, Portsmouth, VA 23703 | 2017-06-02 |
| 1881126019 | Anas Elmahdi | Specialist | 5205 Sweetbriar C., 5205 Sweetbriar C., Portsmouth, VA 23703 | 2017-03-28 |
| 1578003554 | Elyse Buttery | Nurse Practitioner | Mast One 1040 University Blvd, Suite 200, Portsmouth, VA 23703 | 2017-02-24 |
| 1376948349 | Charles Douglas Knight | Military Health Care Provider | Uss Maryland Ssbn 738, Fpo, AA 23703 | 2014-11-03 |
| 1689929382 | Positive Connections, Inc | Community/Behavioral Health | 3823d Meherrin River Reach, Portsmouth, VA 23703 | 2012-07-18 |
| 1225319874 | Sanaz Namin | Pharmacist | 5601 High Street, Porstmouth, VA 23703 | 2011-09-08 |
| 1295029767 | Maggie Jackson | Dental Hygienist | 4000 Coast Guard Blvd., Portsmouth, VA 23703 | 2011-06-02 |
| 1679804892 | Amy Kathleenn Gaspar | Specialist/Technologist, Other | 4113 Pendleton Rd, Portsmouth, VA 23703 | 2010-01-28 |
| Find all providers in zip 23703 | ||||
| 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 |
|---|---|---|---|---|
| 1447858345 | Jamie Mehaffey | Home Health | 1605 Kinneys Ln, Portsmouth, OH 45662-3115 | 2020-10-13 |
| 1356951768 | Hearts of Life | Home Health | 1014 Christiana Cir, Portsmouth, VA 23703-3159 | 2020-07-31 |
| 1134756372 | Heart Felt Home Health | Home Health | 1505 Des Moines Ave, Portsmouth, VA 23704-4301 | 2020-03-26 |
| 1922646504 | Homeworksva | Home Health | 200 High St # Uite201, Portsmouth, VA 23704-3721 | 2019-12-14 |
| 1750928453 | Top Priority Personal Home Care | Home Health | 4424 Winchester Dr # 2, Portsmouth, VA 23707-2825 | 2019-12-02 |
| 1437792959 | Roz & James,llc | Home Health | 4397 Portsmouth Blvd, Portsmouth, VA 23701 | 2019-10-28 |
| 1568016210 | A Special Touch Home Health Care, LLC | Home Health | 3026 Tyre Neck Rd Ste I, Portsmouth, VA 23703-4500 | 2019-07-31 |
| 1780237735 | A Better Way for Seniors, Inc. | Home Health | 10 Vaughan Mall Ste 209, Portsmouth, NH 03801-4047 | 2019-07-18 |
| 1275192221 | Community Choice, LLC. | Home Health | 7318 Ohio River Rd Ste B, Portsmouth, OH 45662-5665 | 2019-06-12 |
| 1891258794 | Cassandra Tyson | Home Health | 2355 Elliott Ave Apt B, Portsmouth, VA 23702-1380 | 2019-04-09 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 23703 |
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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.