NPIMap

Organization Active NPI

Healthaccess, Inc.

Doing business as Vidant Home Health and Hospice

  • Community Based Hospice Care Agency
  • Greenville, NC
National Provider Identifier
1073516894
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOS1711 Issued in NC
Legal business name
HEALTHACCESS, INC.
Doing business as
Vidant Home Health and Hospice
Practice address
1005 W H Smith Blvd
Greenville, NC 27834-5052
Phone
(252) 847-7830
Fax
(252) 847-7910
NPI assigned
May 24, 2005
Last updated
Sep 25, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Authorized official

Name
Mr. Ryan Todd Hickey
Title
President
Phone
(252) 847-7836

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOS0425 NC
Community Based Hospice Care Agency 251G00000X HOS1711 NC Primary

Addresses

Primary practice location

1005 W H Smith Blvd
Greenville, NC 27834-5052

Mailing address

PO Box 8125
Greenville, NC 27835-8125
Phone (252) 847-7830

Other identifiers 2

IdentifierTypeStateIssuer
3411518MedicaidNC
001FUOtherNCPROVIDER NUMBER

Other names 1

  • Vidant Home Health and Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051222000191 NC Part A Provider - Hospice 5395658322 Practice locations: Ahoskie, NC; Greenville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073516894. Details of each certification follow.

Hospice certification: CCN 341518

Legal name
HEALTHACCESS, INC.
Doing business as
ECU HEALTH HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 4, 1987
Last certification
Feb 13, 2015
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Aug 18, 1983 in NC
Enrollment address
521 Myers St W
Ahoskie, NC 27910-3811

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Vidant Home Health and HospiceCCN 341518 · All quality measures
Ownership
Non-Profit
Certified
Nov 4, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Scott Respess Individual Operational/Managerial ControlManager, Patient Care Mar 7, 2024
Jacquelyn Fulghum Music Individual W-2 Managing EmployeeDirector Aug 10, 2014
Melissa Snyder Individual Operational/Managerial ControlManager - Clinical/Therapy Mar 7, 2024
Angela Lassiter Individual Operational/Managerial ControlManager- Patient Care Mar 7, 2024
Abigail Lee Mazingo Individual Operational/Managerial ControlNurse Practitioner Mar 7, 2024
Scottie Simmons Individual W-2 Managing EmployeeManager Sep 9, 2012
David S Hughes Individual Corporate OfficerSecretary/Treasurer Feb 6, 2012
University Health Systems of Eastern Carolina, Inc. Organization, Greenville, NC Corporation 5% Or Greater Direct Ownership Interest Nov 24, 1998 100%
Other Nov 24, 1998 100%
Margaret R Clifton Individual Operational/Managerial ControlMedical Director Mar 7, 2024
Cecelia Theisen Individual Operational/Managerial ControlClinical Supv Mar 7, 2024
Daniel Drake Individual Corporate OfficerPresident Jul 8, 2019
Michael R Waldrum Individual Corporate DirectorDirector and Ceo Jun 1, 2015
James Zambardino Individual Operational/Managerial ControlClinical Director Mar 7, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569369600000",
    "number": "1073516894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8125",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278358125",
            "telephone_number": "252-847-7830",
            "fax_number": "252-847-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345052",
            "telephone_number": "252-847-7830",
            "fax_number": "252-847-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHACCESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2019-09-25",
        "status": "A",
        "authorized_official_last_name": "HICKEY",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-847-7836",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS0425",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS1711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3411518",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "001FU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vidant Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Vidant Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.