Bennett Home Care Agency

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

BENNETT HOME CARE AGENCY

Practice address

16020 Crossed Talons Rd
Woodbridge, VA 22193-5797

Phone

(703) 597-6529

NPI assigned

Mar 13, 2013

Last updated

Apr 17, 2024By 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

Dr. Abena Fynn Swatson

Title

Administrator

Phone

(703) 597-6529

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477894699. Details of each certification follow.

• CCN 497816 Home health agency · Active · Details

Home health agency certification: CCN 497816

Legal name

BENNETT HOME CARE AGENCY

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jul 13, 2024

Last certification

Jul 2, 2024

Organization structure

LLCProprietary

Incorporated

Jul 1, 2012 in VA

Enrollment address

16020 Crossed Talons Rd
Woodbridge, VA 22193-5797
HHA Branch

Listed as

Bennett Home Care AgencyCCN 497816 · All quality measures

Ownership

-

Certified

Jul 13, 2024

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1477894699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16020 CROSSED TALONS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935797",
            "telephone_number": "703-597-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16020 CROSSED TALONS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935797",
            "telephone_number": "703-597-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT HOME CARE AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "FYNN SWATSON",
        "authorized_official_first_name": "ABENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-597-6529",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annetta Serena Benjamin, LPC
• Christine Marie Benjamin, DSP
• Powum Bennam, PHARMD
• Ehab Bennasir
• Bennett Group Home LLC
• Danielle Renee Benninghoff
• N'Dea Bryauna Benson
• Kambeez Berenji, MD
• Benjamin F Berger, B.S.
• Tatiana L Bergstrom, MA, LSATP

• Home Health Agency in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; 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.