Southcoast Visiting Nurse Association. Inc

Organization Active NPI Home Health Agency · Fairhaven, MA

NPI 1104937697 · NPPES record last updated Nov 5, 2025

Key facts

NPI
1104937697
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
2211 (RI)
Legal business name
SOUTHCOAST VISITING NURSE ASSOCIATION. INC
Practice address
200 Mill Road, Suite 120
Fairhaven, MA 02719
Phone
(508) 973-3210
Fax
(508) 973-3215
NPI assigned
Aug 31, 2006
Organization subpart
No

Authorized official

Name
Fernanda Johnson, PT, DPT
Title
President/Ceo
Phone
(508) 973-3200

Owners & managing parties with NPI records 4

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Affiliated clinicians 239

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

View all 239

Medicare Care Compare: Home health agency

Listed as
Southcoast Visiting Nurse Association Inc CCN 227101
Overall star rating
★★★★☆ 3.5 of 5
Ownership
Non-Profit
Certified
Jul 1, 1966
Medicare certification status
Active (Provider of Services file)
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Home health agency certification: CCN 227101

Legal name
SOUTHCOAST VISITING NURSE ASSOCIATION, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 1, 1966
Last certification
Oct 7, 2019
Ownership / control type
Non-Profit
Organization structure
Corporation · Non-profit
Incorporated
Jan 1, 1925 in MA
Enrollment address
200 Mill Road
Fairhaven, MA 02719-5252
HHA Branch

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Patricia Buiocchi
Individual
Corporate Officer Apr 1, 2022
Miguel B Brillantes
Individual
Corporate Director Apr 1, 2022
Jeffrey Lawrence
Individual
Corporate Director Apr 1, 2022
Renee Clark
Individual
Corporate Director Apr 1, 2022
Rayford Kruger
Individual
Corporate Director Apr 1, 2022
Curtis Mello
Individual
Corporate Director Apr 1, 2022
Paul Velho
Individual
Corporate Director
Finance Manager
May 1, 2022
W-2 Managing Employee May 1, 2022
Wade Broughman
Individual
Corporate Director Apr 1, 2022
Linda Fagioli
Individual
Operational/Managerial Control May 1, 2022
Chandra S Reddivari
Individual
Corporate Director Apr 1, 2022

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071121000486 MA Part a Provider - Home Health Agency 5193637189 Practice locations: Fairhaven, MA

National Provider Directory

Tax ID family
Hospice and Palliative Care (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 2211 RI Yes

Addresses

Primary practice location

200 Mill Road, Suite 120
Fairhaven, MA 02719

Mailing address

200 Mill Rd Ste 120
Fairhaven, MA 02719-5252
Phone (508) 973-3200

Other identifiers

IdentifierTypeStateIssuer
0007826OtherMANEIGHBORHOOD HEALTH PLAN
VN01327MedicaidRI
800878OtherMATUFT'S
0603082OtherMABRISTOL ELDER SERVICES
201491OtherRIBLUE CHIP
60-00162OtherMAUNITED HEALTH
800878OtherRITUFT'S
700288OtherMAPILGRIM HEALTH CARE
60-00162OtherRIUNITED HEALTH
001212OtherMASENIOR WHOLE HEALTH
VN23910OtherRIRI DPT HUMAN SERVICE
000000021838OtherMABMC HEALTHNET PLAN
0469887OtherMAUS HEALTHCARE
0603082MedicaidMA
5813-1OtherRIRI BLUE CROSS
120-101OtherMAHMO BLUE-BC/BS

Other providers in Fairhaven, MA

All providers in Fairhaven, MA · Home Health Agency in Massachusetts

Sources for this page

Verify at the official NPI Registry.