NPIMap

Organization Active NPI

Heavenly Hands Healthcare, LLC

  • Home Health Agency
  • Bristol, VA
National Provider Identifier
1124374236
Registry record updated Jul 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
27326 Issued in VA
Legal business name
HEAVENLY HANDS HEALTHCARE, LLC
Practice address
151 Reedy St
Bristol, VA 24201-3126
Phone
(423) 646-1560
NPI assigned
Jul 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2012

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

Authorized official

Name
Ametha Cherie Broadwater, LPNNPI 1669728754
Title
Owner
Phone
(423) 646-1560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 27326 VA Primary
Home Health Agency 251E00000X 2012 24558 TN

Addresses

Primary practice location

151 Reedy St
Bristol, VA 24201-3126

Mailing address

151 Reedy St
Bristol, VA 24201-3126

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1124374236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 REEDY ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 REEDY ST",
            "city": "BRISTOL",
            "state": "VA",
            "postal_code": "242013126",
            "telephone_number": "423-646-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY HANDS HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "BROADWATER",
        "authorized_official_first_name": "AMETHA",
        "authorized_official_middle_name": "CHERIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-646-1560",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "27326",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TN",
            "license": "2012 24558",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.