Organization Active NPI

Dominion Evercare Home Agency LLC

  • In Home Supportive Care Agency
  • Glen Allen, VA
National Provider Identifier
1144171364
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
DOMINION EVERCARE HOME AGENCY LLC
Practice address
12138 Grey Oaks Park Rd
Glen Allen, VA 23059-5781
Phone
(929) 990-7030
NPI assigned
Feb 4, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Authorized official

Name
Misun Kim
Title
President
Phone
(929) 709-6353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

12138 Grey Oaks Park Rd
Glen Allen, VA 23059-5781

Mailing address

12138 Grey Oaks Park Rd
Glen Allen, VA 23059-5781
Phone (929) 709-6353

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1770163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771459200000",
    "number": "1144171364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12138 GREY OAKS PARK RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595781",
            "telephone_number": "929-709-6353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12138 GREY OAKS PARK RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230595781",
            "telephone_number": "929-990-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINION EVERCARE HOME AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-04",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MISUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-709-6353"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2026; 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.