NPIMap

Organization Active NPI

Magnolia Home Care LLC

  • In Home Supportive Care Agency
  • Chesapeake, VA
National Provider Identifier
1366816985
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
0001062 Issued in CT
Legal business name
MAGNOLIA HOME CARE LLC
Practice address
921 Lee Shore Court
Chesapeake, VA 23320-0734
Phone
(866) 866-2465
Fax
(866) 866-2465
NPI assigned
Nov 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Mrs. Charity D Ford, MSW
Title
President
Phone
(757) 831-2968

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 0001062 CT Primary

Addresses

Primary practice location

921 Lee Shore Court
Chesapeake, VA 23320-0734

Mailing address

921 Lee Shore CT
Chesapeake, VA 23320-0734
Phone (866) 866-2465

Other identifiers 1

IdentifierTypeStateIssuer
0001062OtherCTHOME CARE LICENSE NUMBER

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1366816985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 LEE SHORE CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200734",
            "telephone_number": "866-866-2465",
            "fax_number": "866-866-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 LEE SHORE COURT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200734",
            "telephone_number": "866-866-2465",
            "fax_number": "866-866-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "CHARITY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-831-2968",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "CT",
            "license": "0001062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE LICENSE NUMBER",
            "identifier": "0001062",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.