Individual provider Active NPI

Annette Wanki

  • In Home Supportive Care Agency
  • Newport News, VA
National Provider Identifier
1306453949
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
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

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
1254767VAMDGerontology Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.