Providence Home Health, LLC

Primary specialty

Registered NurseTaxonomy code 163W00000X

Legal business name

PROVIDENCE HOME HEALTH, LLC

Practice address

5568 General Washington Dr Ste A201
Alexandria, VA 22312-2465

Phone

(571) 295-6991

Fax

(877) 852-6352

NPI assigned

Oct 19, 2020

Last updated

Oct 19, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia A Bardwell

Title

President

Phone

(703) 705-2112

Specialties & licenses 12

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stella Nancy Morgan-Bendu, LPN

  • Licensed Practical Nurse
  • Alexandria, VA
  • NPI 1457959827
  NPD
• Victor Sepha Morgan, BSN, RN

  • Home Health Registered Nurse
  • Alexandria, VA
  • NPI 1891393252
  NPD

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

{
    "created_epoch": "1603065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1205435567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5568 GENERAL WASHINGTON DR STE A201",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223122465",
            "telephone_number": "703-705-2112",
            "fax_number": "877-852-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5568 GENERAL WASHINGTON DR STE A201",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223122465",
            "telephone_number": "571-295-6991",
            "fax_number": "877-852-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "BARDWELL",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-705-2112",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wanna Prommart, PSYD
• Pronurse Homecare and Infusion
• Prospera Counseling and Consulting PLLC
• Laura Provenzano, PA-C
• Providence Care Transport LLC (Providence Care Medical Transport)
• Providence Partners Health Care Inc
• Chettia Provost, DC
• Katherine Prudden, LCSW
• Emily Prusator, LCSW
• Kathleen H. Prussian, FNP-C

• Registered Nurse in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Registered Nurse in Virginia

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