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Organization Active NPI

Home Nursing Service of Southwest Virginia, Inc.

  • Home Health Agency
  • Abingdon, VA
National Provider Identifier
1306830559
Registry record updated Feb 27, 2012
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Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
0000364000402 Issued in VA
Legal business name
HOME NURSING SERVICE OF SOUTHWEST VIRGINIA, INC.
Practice address
611 Campus Dr
Suite 300
Abingdon, VA 24210-9700
Phone
(276) 628-2666
Fax
(276) 623-4276
NPI assigned
Sep 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2012

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

Authorized official

Name
Mrs. Judy L. Wilson, LPN
Title
Administrator
Phone
(276) 628-2666

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 0000364000402 VA Primary

Addresses

Primary practice location

611 Campus Dr
Suite 300
Abingdon, VA 24210-9700

Mailing address

611 Campus Dr
Suite 300
Abingdon, VA 24210-9700
Phone (276) 628-2666

Other identifiers 2

IdentifierTypeStateIssuer
004973062MedicaidVA
006655OtherVABCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050221000655 VA Part A Provider - Home Health Agency 2163475963 Practice locations: Abingdon, VA

Home health agency certification: CCN 497044

Legal name
HOME NURSING SERVICE OF SOUTHWEST VIRGINIA, INC.
Doing business as
HOME NURSING SERVICE OF SOUTHWEST VA, INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 25, 1985
Last certification
Jun 30, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Mar 11, 1985 in VA
Enrollment address
26104 Lee Hwy
Abingdon, VA 24211-7502

Care Compare: Home health agency

Medicare Care Compare
Listed as
Home Nursing Services of Southwest VA IncCCN 497044
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Apr 25, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

26104 Lee Hwy
Abingdon, VA 24211
Phone (276) 628-2001

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Judy Wilson Individual Corporate OfficerVP of Operations Feb 20, 2015
Corporate DirectorAdministrator May 11, 1995
W-2 Managing EmployeeAdministrator May 11, 1995
Carol Clifton Individual 5% Or Greater Direct Ownership InterestSecretary Feb 26, 2014 100%
Corporate OfficerSecretary Mar 15, 1985 50%

Practitioners & affiliated clinicians

Affiliated clinicians 9

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1306830559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 CAMPUS DR",
            "address_2": "SUITE 300",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242109700",
            "telephone_number": "276-628-2666",
            "fax_number": "276-623-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 CAMPUS DR",
            "address_2": "SUITE 300",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242109700",
            "telephone_number": "276-628-2666",
            "fax_number": "276-623-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME NURSING SERVICE OF SOUTHWEST VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "276-628-2666",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "0000364000402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004973062",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "006655",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

Verify at the official NPI Registry.