Active NPI
Personal Homecare, Inc.
- In Home Supportive Care Agency
- South Boston, VA
National Provider Identifier
1063805166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 8702594
- Legal business name
- PERSONAL HOMECARE, INC.
- Practice address
- 425 Main St
South Boston, VA 24592-3241 - Phone
- (434) 572-1028
- NPI assigned
- Mar 13, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alfred Lee Burkholder III
- Title
- President/Ceo
- Phone
- (434) 572-1582
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Emergency Response Attendant | 146D00000X | |||
| Case Management Agency | 251B00000X | |||
| In Home Supportive Care Agency | 253Z00000X | 8702594 | VA | Primary |
| Emergency Response System Companies | 333300000X | |||
| Respite Care | 385H00000X | |||
| Child Mental Illness Respite Care | 385HR2055X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Child Physical Disabilities Respite Care | 385HR2065X |
Addresses
Primary practice location
425 Main St
South Boston, VA 24592-3241
Mailing address
PO Box 1006
South Boston, VA 24592-1006
Phone (434) 572-1028
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8751111 | Medicaid | VA | |
| 9106235 | Medicaid | VA | |
| 9106251 | Medicaid | VA | |
| 8702411 | Medicaid | VA | |
| 9119868 | Medicaid | VA | |
| 8771677 | Medicaid | VA | |
| 8702594 | Medicaid | VA | |
| 8704368 | Medicaid | VA | |
| 8771693 | Medicaid | VA | |
| 8773289 | Medicaid | VA | |
| 8751013 | Medicaid | VA | |
| 8751498 | Medicaid | VA |
Other names 1
- 1st Care At Home
National Provider Directory
National Provider Directory- Tax ID family
- 1St Care at Home
Other organizations with this tax ID 6
Organizations that report the same tax identification number in the National Provider Directory.
-
- In Home Supportive Care Agency
- South Boston, VA
- NPI 1114006962
-
- In Home Supportive Care Agency
- Lynchburg, VA
- NPI 1396839312
-
- Home Health Agency
- South Boston, VA
- NPI 1811035645
-
- Nursing Care Agency
- Lynchburg, VA
- NPI 1821139379
-
- In Home Supportive Care Agency
- South Hill, VA
- NPI 1881773638
-
- Nursing Care Agency
- South Hill, VA
- NPI 1891833638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700438400000",
"number": "1063805166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1006",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245921006",
"telephone_number": "434-572-1028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 MAIN ST",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245923241",
"telephone_number": "434-572-1028"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PERSONAL HOMECARE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-13",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A",
"authorized_official_last_name": "BURKHOLDER",
"authorized_official_first_name": "ALFRED",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "434-572-1582",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "146D00000X",
"taxonomy_group": "",
"desc": "Personal Emergency Response Attendant",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "VA",
"license": "8702594",
"primary": true
},
{
"code": "333300000X",
"taxonomy_group": "",
"desc": "Emergency Response System Companies",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8751111",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9106235",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9106251",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8702411",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9119868",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8771677",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8702594",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8704368",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8771693",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8773289",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8751013",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8751498",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "1st Care At Home",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.