Active NPI
Supreme Health Care Services
- Home Health Agency
- Portsmouth, VA
National Provider Identifier
1386838571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- SUPREME HEALTH CARE SERVICES
- Practice address
- 3300 Tyre Neck Road
Suite F
Portsmouth, VA 23703-3319 - Phone
- (757) 393-0327
- Fax
- (757) 393-0328
- NPI assigned
- Aug 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. John Omonkhuale Madojemu, MSM, PHD (C)
- Title
- Program Director
- Phone
- (757) 393-0327
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Home Health Agency | 251E00000X | Primary | ||
| Home Infusion Agency | 251F00000X | |||
| Community Based Hospice Care Agency | 251G00000X | |||
| Nursing Care Agency | 251J00000X | |||
| Assisted Living Facility | 310400000X | |||
| Assisted Living Facility (Mental Illness) | 3104A0625X | |||
| Custodial Care Facility | 311Z00000X | |||
| Adult Care Home Facility | 311ZA0620X | |||
| Skilled Nursing Facility | 314000000X | |||
| Pediatric Skilled Nursing Facility | 3140N1450X | |||
| Intellectual Disabilities Intermediate Care Facility | 315P00000X | |||
| Child Mental Illness Respite Care | 385HR2055X | |||
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | |||
| Child Physical Disabilities Respite Care | 385HR2065X |
Addresses
Primary practice location
3300 Tyre Neck Road
Suite F
Portsmouth, VA 23703-3319
Mailing address
3300 Tyre Neck Road
Suite F
Portsmouth, VA 23703-3319
Phone (757) 393-0327
National Provider Directory
National Provider DirectoryLocations
3300 Tyre Neck Rd
Ste F
Portsmouth, VA 23703
Phone (757) 393-0327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1343952000000",
"number": "1386838571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 TYRE NECK ROAD",
"address_2": "SUITE F",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237033319",
"telephone_number": "757-393-0327",
"fax_number": "757-393-0328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 TYRE NECK ROAD",
"address_2": "SUITE F",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237033319",
"telephone_number": "757-393-0327",
"fax_number": "757-393-0328"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPREME HEALTH CARE SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-30",
"last_updated": "2012-08-03",
"status": "A",
"authorized_official_last_name": "MADOJEMU",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "OMONKHUALE",
"authorized_official_title_or_position": "PROGRAM DIRECTOR",
"authorized_official_telephone_number": "757-393-0327",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MSM, PHD (C)"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": null,
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": false
},
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3104A0625X",
"taxonomy_group": "",
"desc": "Assisted Living Facility, Assisted Living, Mental Illness",
"state": null,
"license": null,
"primary": false
},
{
"code": "311Z00000X",
"taxonomy_group": "",
"desc": "Custodial Care Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": null,
"license": null,
"primary": false
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": null,
"license": null,
"primary": false
},
{
"code": "315P00000X",
"taxonomy_group": "",
"desc": "Intermediate Care Facility, Intellectual Disabilities",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2060X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2065X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Physical Disabilities, Child",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.