Senior Home Share, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SENIOR HOME SHARE, LLC

Practice address

1002 E Stuart Dr Ste 3
Galax, VA 24333-2664

Phone

(276) 238-1448

Fax

(276) 601-2587

NPI assigned

Feb 27, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jackie D. Fox

Title

Sole Member

Phone

(276) 238-1448

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1003373952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 E STUART DR STE 3",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332664",
            "telephone_number": "276-238-1448",
            "fax_number": "276-601-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 E STUART DR STE 3",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243332664",
            "telephone_number": "276-238-1448",
            "fax_number": "276-601-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR HOME SHARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "276-238-1448",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "E24637778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• S W Campbell OD PC
• Fawzia Salahuddin, MD, MHS-CL, FACP.
• Emil William Sandstrom, LCSW
• Karen Sapp, LPN
• Catorra Leigh Schulte
• Ryan Patrick Shaffner, B.S.
• Michael M Shanks, CRNA
• Ashley Nicole Sharp, LPTA
• Lauranne Toler Shore, MED, CAADC
• Nancy Sue Shupe, LPC

• Home Health Agency in Galax, VA
• Providers in Galax, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.