Nova Home Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

550001679 Issued in CA

Legal business name

NOVA HOME HOSPICE INC.

Practice address

1551 W 13TH St
Suite 104
Upland, CA 91786-2900

Phone

(909) 946-1213

Fax

(909) 946-1214

NPI assigned

Aug 1, 2013

Last updated

Aug 1, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Wilma E. Cambe

Title

Ceo

Phone

(909) 946-1213

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447682430. Details of each certification follow.

• CCN 751654 Hospice · Active · Details

Hospice certification: CCN 751654

Legal name

NOVA HOME HOSPICE INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 22, 2015

Last certification

Sep 16, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 19, 2008 in CA

Enrollment address

1551 W. 13TH Street
Suite 104
Upland, CA 91786-2993

Listed as

Nova Home Hospice IncCCN 751654 · All quality measures

Ownership

For-Profit

Certified

Jun 22, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Nova Home Hospice Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Nova Home Hospice Inc

  • Community Based Hospice Care Agency
  • Upland, CA
  • NPI 1538462148
  NPD tax ID

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Hung M Nguyen, D.O.

  • Family Medicine Physician
  • Orange, CA
  • NPI 1447284526

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Jhoette Archein Magaway Dumlao, M.D.

  • Family Medicine Physician
  • Yakima, WA
  • NPI 1104110105

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1447682430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 W 13TH ST",
            "address_2": "SUITE 104",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862900",
            "telephone_number": "909-946-1213",
            "fax_number": "909-946-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 W 13TH ST",
            "address_2": "SUITE 104",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862900",
            "telephone_number": "909-946-1213",
            "fax_number": "909-946-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA HOME HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "CAMBE",
        "authorized_official_first_name": "WILMA",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-946-1213",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CA",
            "license": "550001679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Marie Norris
• North Star Psychological Services P.C.
• Thia M Norton Bell
• Nova Home Health Inc.
• Nova Home Hospice Inc
• Nova Homehealth, Inc.
• Adam J Novak, M.D.
• Nurtured Minds
• Nutrition Counseling Plus
• Matthew Jordan Nykiel, M.D.

• Community Based Hospice Care Agency in Upland, CA
• Providers in Upland, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.