Amazing Grace Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HCO141040 Issued in VA

Legal business name

AMAZING GRACE HOME HEALTH CARE LLC

Practice address

3940 Airline Blvd
118
Chesapeake, VA 23321-3329

Phone

(757) 606-3170

Fax

(757) 606-3993

NPI assigned

Jun 14, 2013

Last updated

Jul 24, 2014By 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

Andrea Niccoya Jackson

Title

Owner/Manager

Phone

(757) 606-3170

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406160000000",
    "number": "1275971095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 AIRLINE BLVD",
            "address_2": "118",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213329",
            "telephone_number": "757-606-3170",
            "fax_number": "757-606-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 AIRLINE BLVD",
            "address_2": "118",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233213329",
            "telephone_number": "757-606-3170",
            "fax_number": "757-606-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-14",
        "last_updated": "2014-07-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "NICCOYA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "757-606-3170"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO141040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2014; 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.