NPIMap

Organization Active NPI

123 Pediatric Home Healthcare Corporation

  • Home Health Agency
  • Verona, PA
National Provider Identifier
1245696434
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
06400501 Issued in PA
Legal business name
123 PEDIATRIC HOME HEALTHCARE CORPORATION
Practice address
6309 Hallwood Dr
Verona, PA 15147-2526
Phone
(412) 377-9102
NPI assigned
Jan 5, 2016
Last updated
Apr 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Authorized official

Name
Mrs. Lisa Juanita Washington, RNNPI 1912362203
Title
Chief Executive Officer
Phone
(412) 377-9102

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 06400501 PA
Home Health Agency 251E00000X 06400501 PA Primary
Home Infusion Agency 251F00000X 06400501 PA
Nursing Care Agency 251J00000X 06400501 PA
Nursing Care Agency 251J00000X RN620599 PA
Clinical Social Worker 1041C0700X CW017087 PA
General Practice Registered Nurse 163WG0000X RN620599 PA
Home Health Registered Nurse 163WH0200X RN620599 PA
Infusion Therapy Registered Nurse 163WI0500X RN620599 PA
Pediatric Registered Nurse 163WP0200X RN620599 PA
Pediatric Oncology Registered Nurse 163WP0218X RN620599 PA
Wound Care Registered Nurse 163WW0000X RN620599 PA
Oncology Registered Nurse 163WX0200X RN620599 PA
In Home Supportive Care Agency 253Z00000X 30153601 PA

Addresses

Primary practice location

6309 Hallwood Dr
Verona, PA 15147-2526

Mailing address

6309 Hallwood Dr
Verona, PA 15147-2526
Phone (412) 377-9102

Other identifiers 4

IdentifierTypeStateIssuer
1030784200001OtherPASTATE OF PA DHS OFFICE OF INTELLECTUAL DISABILITIES PROVIDER NUMBER
06400501OtherPASTATE OF PENNSYLVANIA
1030784200002OtherPASTATE OF PA DHS OFFICE OF LONG TERM LIVING PROVIDER NUMBER
30153601OtherPASTATE OF PENNSYLVANIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1451952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1245696434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 HALLWOOD DR",
            "city": "VERONA",
            "state": "PA",
            "postal_code": "151472526",
            "telephone_number": "412-377-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 HALLWOOD DR",
            "city": "VERONA",
            "state": "PA",
            "postal_code": "151472526",
            "telephone_number": "412-377-9102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "123 PEDIATRIC HOME HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-05",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "WASHINGTON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "JUANITA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "412-377-9102",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "PA",
            "license": "06400501",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "06400501",
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "PA",
            "license": "06400501",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "PA",
            "license": "06400501",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017087",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WP0218X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatric Oncology",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "PA",
            "license": "RN620599",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": "30153601",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF PA DHS OFFICE OF INTELLECTUAL DISABILITIES PROVIDER NUMBER",
            "identifier": "1030784200001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF PENNSYLVANIA",
            "identifier": "06400501",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF PA DHS OFFICE OF LONG TERM LIVING PROVIDER NUMBER",
            "identifier": "1030784200002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF PENNSYLVANIA",
            "identifier": "30153601",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.