Grace Home Healthcare, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRACE HOME HEALTHCARE, LLC

Practice address

9735 Main Street
Suite 200
Fairfax, VA 22031-3736

Phone

(703) 865-7370

Fax

(703) 865-5520

NPI assigned

Feb 12, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Matthew Auman

Title

Ceo

Phone

(410) 486-5330

Specialties & licenses 1

Addresses

Other names 1

• HomeCentris Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Home health agency certification: CCN 497754

Legal name

GRACE HOME HEALTHCARE LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 26, 2018

Last certification

Jan 26, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

Apr 30, 2014 in VA

Enrollment address

9735 Main St
Ste 200
Fairfax, VA 22031-3736

Listed as

Grace Home Healthcare LLCCCN 497754

Ownership

Proprietary

Certified

Jan 26, 2018

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Physical therapy

Locations

All disclosed owners & managing parties 12

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

Facilities with the same owner 1

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

• Homecentris Home Health II, LLC

  • Home Health Agency
  • Owings Mills, MD
  • NPI 1487113239

  Homecentris Healthcare LLC, Interprise Holdings, LLC, Oak Forest Partners LLC, Spring Capital Partners III, L.P.

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Young-Lan Kim

  • Registered Nurse
  • Fairfax, VA
  • NPI 1922513472
  NPD (past)

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1073904009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CROSSROADS DRIVE",
            "address_2": "SUITE 110",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "21117",
            "telephone_number": "410-486-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9735 MAIN STREET",
            "address_2": "SUITE 200",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313736",
            "telephone_number": "703-865-7370",
            "fax_number": "703-865-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-12",
        "last_updated": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "AUMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-486-5330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeCentris Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Ann Gouzd, M.D.
• Murliya D Gowda, M.D.
• Anjali Goyal, MD
• Shaveta Goyal, M.D.
• Sydnee Goyer, MD
• Grace Korean Church
• Brianna Grady
• Christopher Kevin Grady, MD
• Malgorzata Gradzka, M.D.
• Sarah Gragan

• Home Health Agency in Fairfax, VA
• Providers in Fairfax, 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 May 7, 2024; 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.