Mary Elizabeth Nursing Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MARY ELIZABETH NURSING SERVICES, INC.

Practice address

2622 Poplar St Apt 1
Philadelphia, PA 19130-1363

Phone

(215) 455-4104

NPI assigned

Apr 28, 2021

Last updated

Apr 28, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sylvester Bailey III

Title

President

Phone

(252) 702-1371

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023690096. Details of each certification follow.

• CCN 398373 Home health agency · Active · Details

Home health agency certification: CCN 398373

Legal name

MARY ELIZABETH NURSING SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 11, 2024

Last certification

Sep 20, 2024

Organization structure

CorporationProprietary

Incorporated

Apr 1, 2021 in PA

Enrollment address

2622 Poplar St
Apt 1
Philadelphia, PA 19130-1363
HHA Branch

Listed as

Mary Elizabeth Nursing Services, Inc.CCN 398373 · All quality measures

Ownership

-

Certified

Oct 11, 2024

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1023690096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26221",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191416221",
            "telephone_number": "215-455-4104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 POPLAR ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301363",
            "telephone_number": "215-455-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY ELIZABETH NURSING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "SYLVESTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-702-1371",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.