Prima Home Health, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HCO07424 Issued in VA

Legal business name

PRIMA HOME HEALTH, INC

Practice address

14101 Willard Road
Ste C
Chantilly, VA 20151-2934

Phone

(703) 955-7800

Fax

(703) 263-3119

NPI assigned

Apr 6, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Omar M Abdi

Title

Administrator

Phone

(703) 955-7800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Home health agency certification: CCN 497724

Legal name

PRIMA HOME HEALTH, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 31, 2016

Last certification

Jan 24, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 9, 2010 in VA

Enrollment address

14101 Willard Rd
# C
Chantilly, VA 20151-2934

Listed as

Prima Home Health IncCCN 497724

Ownership

Proprietary

Certified

Mar 31, 2016

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

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

• Zeitu Agza

  • Nurse's Aide
  • Chantilly, VA
  • NPI 1083268924
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1164545240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14101 WILLARD ROAD",
            "address_2": "STE C",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512934",
            "telephone_number": "703-955-7800",
            "fax_number": "703-263-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14101 WILLARD ROAD",
            "address_2": "STE C",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512934",
            "telephone_number": "703-955-7800",
            "fax_number": "703-263-3119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMA HOME HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "ABDI",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-955-7800",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO07424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164545240",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.