NPIMap

Organization Active NPI

Personal Homecare Inc

Doing business as 1st Care at Home

  • In Home Supportive Care Agency
  • South Boston, VA
National Provider Identifier
1114006962
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PERSONAL HOMECARE INC
Doing business as
1st Care at Home
Practice address
425 Main Street
South Boston, VA 24592
Phone
(434) 572-1028
Fax
(434) 572-2631
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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
Phone
(434) 572-1582

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X EXEMPT VA
In Home Supportive Care Agency 253Z00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X VA
Emergency Response System Companies 333300000X
Respite Care 385H00000X
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

425 Main Street
South Boston, VA 24592

Mailing address

425 Main Street
South Boston, VA 24592
Phone (434) 572-1028

Other identifiers 4

IdentifierTypeStateIssuer
8751013MedicaidVA
00875111MedicaidVA
009106235MedicaidVA
104815OtherVAPRIVATE DUTY NURSING

Other names 1

  • 1st Care at Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
1St Care at Home7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1114006962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MAIN STREET",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "24592",
            "telephone_number": "434-572-1028",
            "fax_number": "434-572-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MAIN STREET",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "24592",
            "telephone_number": "434-572-1028",
            "fax_number": "434-572-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL HOMECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "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",
        "authorized_official_telephone_number": "434-572-1582",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "VA",
            "license": "EXEMPT",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8751013",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00875111",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009106235",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE DUTY NURSING",
            "identifier": "104815",
            "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.

Verify at the official NPI Registry.