Medina Healthcare Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEDINA HEALTHCARE SERVICES LLC

Practice address

8639 Engleside Office Park Ste C
Alexandria, VA 22309-4132

Phone

(571) 775-1846

NPI assigned

Aug 11, 2020

Organization subpart

No

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

Authorized official

Name

Mrs. Chikata Khyne-Sam

Title

Owner

Phone

(571) 775-1846

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1597104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1124639471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8639 ENGLESIDE OFFICE PARK STE C",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223094132",
            "telephone_number": "571-775-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8639 ENGLESIDE OFFICE PARK STE C",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223094132",
            "telephone_number": "571-775-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "KHYNE-SAM",
        "authorized_official_first_name": "CHIKATA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-775-1846",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2020; 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.