Organization Active NPI

Home Health Aide

  • Custodial Care Facility
  • Hampton, VA
National Provider Identifier
1154760916
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
1401009775 Issued in VA
Legal business name
HOME HEALTH AIDE
Practice address
625 Newport News Ave
Hampton, VA 23669-3930
Phone
(757) 722-4504
NPI assigned
Jun 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Authorized official

Name
Mrs. Melanie Denise Cobb, CNA
Title
Certified Nursing Assistant
Phone
(757) 722-4504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X 1401009775 VA Primary

Addresses

Primary practice location

625 Newport News Ave
Hampton, VA 23669-3930

Mailing address

625 Newport News Ave
Hampton, VA 23669-3930
Phone (757) 722-4504

Other identifiers 1

IdentifierTypeStateIssuer
1401009775OtherVACERTIFIED NURSING ASSISTANT

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1154760916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 NEWPORT NEWS AVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693930",
            "telephone_number": "757-722-4504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 NEWPORT NEWS AVE",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236693930",
            "telephone_number": "757-722-4504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH AIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "COBB",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CERTIFIED NURSING ASSISTANT",
        "authorized_official_telephone_number": "757-722-4504",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "VA",
            "license": "1401009775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSING ASSISTANT",
            "identifier": "1401009775",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2013; 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.