NPIMap

Organization Active NPI

Chesapeake Hospital Authority

  • Community Based Hospice Care Agency
  • Chesapeake, VA
National Provider Identifier
1437155124
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HSP0712 Issued in VA
Legal business name
CHESAPEAKE HOSPITAL AUTHORITY
Practice address
1301 Executive Blvd Ste 200
Chesapeake, VA 23320-3671
Phone
(757) 312-6460
Fax
(757) 312-6477
NPI assigned
Jun 27, 2005
Organization subpart
Yes
Parent organization
CHESAPEAKE HOSPITAL AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Authorized official

Name
Mrs. Amber Egyud, DNP RN
Title
Chief Operating Officer/Chief Nursi
Phone
(757) 312-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HSP0712 VA Primary

Addresses

Primary practice location

1301 Executive Blvd Ste 200
Chesapeake, VA 23320-3671

Mailing address

1301 Executive Blvd Ste 200
Chesapeake, VA 23320-3671
Phone (757) 312-6460

Other identifiers 2

IdentifierTypeStateIssuer
004910362MedicaidVA
HSP-1811OtherVASTATE LICENSE

Other names 1

  • Chesapeake Regional Home & Supportive Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041216001033 VA Part A Provider - Hospice 5092627893 Practice locations: Chesapeake, VA

Hospice certification: CCN 491546

Legal name
CHESAPEAKE HOSPITAL AUTHORITY
Doing business as
CHESAPEAKE REGIONAL HOME & SUPPORTIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 21, 1996
Last certification
Oct 24, 2019
Ownership / control type
Other
Organization structure
OtherNon-profit
Incorporated
Aug 21, 1995 in VA
Enrollment address
1301 Executive Blvd
Ste 200
Chesapeake, VA 23320-3671

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Comfort Care Home Health and HospiceCCN 491546
Ownership
Other
Certified
Nov 21, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kim Whitehurst8 organizations share this tax ID, including this one
Part of
Kim Whitehurst

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

667 Kingsborough Sq
Ste 300
Chesapeake, VA 23320
Phone (757) 422-5476

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Stephen McDonnell Individual Corporate OfficerChief Financial Officer Sep 18, 2017
James Jackson Individual Corporate OfficerCeo Jan 31, 2017
Shemaine L Rose Individual W-2 Managing EmployeeController Jan 31, 2017
Amber L Egyud Individual Corporate OfficerCoo/Chief Nursing Officer Sep 11, 2017

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Outer Banks Health HospitalNags Head, NC, CCN 341324 Hospital Other (40%) Oct 1, 2002

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1437155124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 EXECUTIVE BLVD STE 200",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203671",
            "telephone_number": "757-312-6460",
            "fax_number": "757-312-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 EXECUTIVE BLVD STE 200",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203671",
            "telephone_number": "757-312-6460",
            "fax_number": "757-312-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE HOSPITAL AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHESAPEAKE HOSPITAL AUTHORITY",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "EGYUD",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER/CHIEF NURSI",
        "authorized_official_telephone_number": "757-312-6308",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "VA",
            "license": "HSP0712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004910362",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "HSP-1811",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chesapeake Regional Home & Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.