Healing Home Healthcare Inc.
Organization Active NPI Home Health Agency · Manassas, VA
NPI 1174920573 · NPPES record last updated Sep 14, 2021
Key facts
- NPI
- 1174920573
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- Legal business name
- HEALING HOME HEALTHCARE INC.
- Practice address
- 7000 Infantry Ridge Rd Ste 110
Manassas, VA 20109-2370 - Phone
- (703) 650-0576
- Fax
- (703) 543-9909
- NPI assigned
- Dec 1, 2014
- Organization subpart
- No
Authorized official
- Name
- Gurdev Singh
- Title
- Managing Director
- Phone
- (703) 650-0576
Affiliated clinicians 26
-
Emmaleona Ego Agogbua, APRN, FNP
-
Kyana Anthony, CRNP
-
Ahmad Babar, M.D.
-
Soujanya Biragoni, M.D.
-
Joseph P. David, M.D.
-
David C Evans, MD
-
Amauri L. Gonzalez, M.D.
-
Alok K Gupta, MD
-
Anum Hasan, DO
-
Laura B Hitchcock, FNP
-
Young Kwan Kim, D.O.
-
Robert A W Latimer, M.D.
-
Donald M. Poretz, M.D.
-
Elena G. Saykaly, P.A.
-
Douglas Sigmon, M.D.
Medicare Care Compare: Home health agency
- Listed as
- Healing Home Healthcare Inc
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Dec 29, 2017
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2104748 | Healing Home Healthcare, Inc | Certificate of waiver | Nov 10, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in VA
- Home infusion therapy
- Medicare-enrolled home infusion therapy supplier
Home health agency certification: CCN 497751
- Legal name
- HEALING HOME HEALTHCARE INC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Dec 29, 2017
- Last certification
- Dec 29, 2017
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Nov 5, 2013 in VA
- Enrollment address
- 7000 Infantry Ridge Rd
Ste 110
Manassas, VA 20109-2370
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Gurpreet K Bajwa |
Corporate Officer |
Nov 5, 2013 | |
| Corporate Director |
Nov 5, 2013 | ||
| W-2 Managing Employee | Nov 5, 2013 | ||
| Gurdev Singh |
5% Or Greater Direct Ownership Interest | Nov 5, 2013 | 100% |
| Corporate Officer |
Nov 5, 2013 | ||
| Corporate Director |
Nov 5, 2013 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150610002515 | VA | Part a Provider - Home Health Agency | 9537480918 | Practice locations: Manassas, VA |
| O20210629000233 | VA | Part B Supplier - Home Infusion Therapy Supplier | 9537480918 | Practice locations: Manassas, VA |
National Provider Directory
Locations
8140 Ashton Ave
#112
Manassas, VA 20109
Phone (703) 650-0576
7000 Infantry Ridge Rd
Ste 110
Manassas, VA 20109
Phone (703) 650-0576
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Yes |
Addresses
Primary practice location
7000 Infantry Ridge Rd Ste 110
Manassas, VA 20109-2370
Mailing address
7000 Infantry Ridge Rd Ste 110
Manassas, VA 20109-2370
Phone (703) 650-0576
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174920573 | Medicaid | VA |
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All providers in Manassas, VA · Home Health Agency in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.