Active NPI
Annette Wanki
- In Home Supportive Care Agency
- Newport News, VA
National Provider Identifier
1306453949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 1939 Mortar Loop Apt a
Newport News, VA 23603-1502 - Phone
- (240) 305-5767
- NPI assigned
- Sep 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 12
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Registered Nurse | 163WG0600X | 1254767 | VA | |
| Case Manager/Care Coordinator | 171M00000X | |||
| Case Management Agency | 251B00000X | |||
| Home Health Agency | 251E00000X | |||
| Home Infusion Agency | 251F00000X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Assisted Living Facility | 310400000X | |||
| Skilled Nursing Facility | 314000000X | |||
| Chore Provider | 372500000X | |||
| Adult Companion | 372600000X | |||
| Respite Care | 385H00000X | |||
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
1939 Mortar Loop Apt a
Newport News, VA 23603-1502
Mailing address
5228 Verenda Ave
Twentynine Palms, CA 92277-1780
Phone (240) 305-5767
Other practice location 1
5228 Verenda Ave
Twentynine Palms, CA 92277-1780
Phone (240) 305-5767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1254767 | VA | MD | Gerontology Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Precision Care Health Services, LLC | Case Management | Current | Accepting new patients |
| Precision Care Health Services LLC | In Home Supportive Care | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- In Home Supportive Care Agency
- Fairfax, VA
- NPI 1255027868
-
- In Home Supportive Care Agency
- Washington, DC
- NPI 1003583550
Case Management
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1306453949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5228 VERENDA AVE",
"city": "TWENTYNINE PALMS",
"state": "CA",
"postal_code": "922771780",
"telephone_number": "240-305-5767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1939 MORTAR LOOP APT A",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236031502",
"telephone_number": "240-305-5767"
}
],
"practiceLocations": [
{
"address_1": "5228 Verenda Ave",
"address_purpose": "LOCATION",
"city": "Twentynine Palms",
"state": "CA",
"postal_code": "922771780",
"country_code": "US",
"telephone_number": "240-305-5767",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WANKI",
"first_name": "ANNETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-28",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0600X",
"taxonomy_group": "",
"desc": "Registered Nurse, Gerontology",
"state": "VA",
"license": "1254767",
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
},
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.