NPIMap

Organization Active NPI

Commonwealth Home Health Inc

Doing business as 1st Care Home Health South Boston

  • Home Health Agency
  • South Boston, VA
National Provider Identifier
1487646113
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
COMMONWEALTH HOME HEALTH INC
Doing business as
1st Care Home Health South Boston
Practice address
425 Main St
South Boston, VA 24592-3241
Phone
(434) 572-1312
Fax
(434) 572-6211
NPI assigned
Aug 18, 2005
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Mr. Alfred Lee Burkhold III
Title
Administrator
Phone
(434) 572-1582

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

425 Main St
South Boston, VA 24592-3241

Mailing address

PO Box 1006
South Boston, VA 24592-1006
Phone (434) 572-1312

Other identifiers 2

IdentifierTypeStateIssuer
226503OtherVAANTHEM
4970217MedicaidVA

Other names 1

  • 1st Care Home Health South Boston Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000627 VA Part A Provider - Home Health Agency 1557266327 Practice locations: South Boston, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487646113. Details of each certification follow.

Home health agency certification: CCN 497021

Legal name
COMMONWEALTH HOME HEALTH INC
Doing business as
1ST CARE HOME HEALTH SOUTH BOSTON
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jul 25, 1985
Last certification
May 7, 2021
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Dec 30, 1986 in VA
Enrollment address
425 Main St
South Boston, VA 24592-3241

Care Compare: Home health agency

Medicare Care Compare
Listed as
1St Care Home Health South BostonCCN 497021 · All quality measures
Overall star rating
3.5 of 5
Ownership
Proprietary
Certified
Jul 25, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory

Locations

425 Main St
South Boston, VA 24592
Phone (434) 572-1312

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
Alfred Lee Burkholder Jr Estate Organization, South Boston, VA 5% Or Greater Direct Ownership Interest May 22, 2022 100%
Alfred Lee Burkholder Individual Corporate OfficerPresident May 22, 2022 100%
Corporate DirectorPresident May 22, 2022 100%
W-2 Managing EmployeePresident May 22, 2022 100%
Operational/Managerial ControlPresident May 22, 2022 100%
First Care Health Services, Inc. Organization, South Boston, VA Corporation, Chain home office Operational/Managerial Control Apr 1, 2002 100%
Lori B Frazier Individual W-2 Managing EmployeeProgram Director Dec 1, 2015

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1487646113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1006",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921006",
            "telephone_number": "434-572-1312",
            "fax_number": "434-572-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 MAIN ST",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245923241",
            "telephone_number": "434-572-1312",
            "fax_number": "434-572-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-18",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "BURKHOLD",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-572-1582",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "226503",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4970217",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Care Home Health South Boston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.