Active NPI
Khaiyana Wilson
- Home Health Aide
- Philadelphia, PA
National Provider Identifier
1366203069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- Practice address
- 5508 Pearl St
Philadelphia, PA 19139-2027 - Phone
- (267) 226-4557
- Fax
- (267) 367-5656
- NPI assigned
- Jan 19, 2024
- Last updated
- Jan 22, 2024
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Health Aide | 374U00000X | Primary | ||
| Respite Care | 385H00000X | |||
| In Home Supportive Care Agency | 253Z00000X |
Addresses
Primary practice location
5508 Pearl St
Philadelphia, PA 19139-2027
Mailing address
7244 Castor Ave # 1866
Philadelphia, PA 19149-1109
Phone (267) 452-2386
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mann's Home Care LLC | Home Health | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705881600000",
"number": "1366203069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7244 CASTOR AVE # 1866",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191491109",
"telephone_number": "267-452-2386",
"fax_number": "267-367-5656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5508 PEARL ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191392027",
"telephone_number": "267-226-4557",
"fax_number": "267-367-5656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "KHAIYANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-19",
"last_updated": "2024-01-22",
"certification_date": "2024-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": true
},
{
"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": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.