Edmarc Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EDMARC INC.

Practice address

516 London St
Portsmouth, VA 23704-2510

Phone

(757) 967-9251

Fax

(757) 967-9124

NPI assigned

Jul 6, 2006

Last updated

Oct 22, 2019By 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

Deborah Stitzer-Brame, RN

Title

Executive Director

Phone

(757) 967-9251

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588696181. Details of each certification follow.

• CCN 497263 Home health agency · Active · Details

Home health agency certification: CCN 497263

Legal name

EDMARC INC.

Doing business as

EDMARC HOSPICE FOR CHILDREN

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jun 11, 1982

Last certification

Dec 1, 2020

Ownership / control type

Proprietary

Organization structure

CorporationNon-profit

Incorporated

Nov 28, 1978 in VA

Enrollment address

516 London St
Portsmouth, VA 23704-2510

Listed as

Edmarc Hospice for ChildrenCCN 497263 · All quality measures

Ownership

Proprietary

Certified

Jun 11, 1982

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social

Locations

All disclosed owners & managing parties 22

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 3

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

• Cyrus C Heydarian, MD

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1942462460

  Corporate Director

  CMS ownership
• Ralph S Northam, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Norfolk, VA
  • NPI 1780630145

  Corporate Director

  CMS ownership
• Linda D Pegram, M.D.

  • Pediatric Hematology & Oncology Physician
  • Norfolk, VA
  • NPI 1023064664

  Corporate Director

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ralph S Northam, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Norfolk, VA
  • NPI 1780630145
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1588696181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 LONDON ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042510",
            "telephone_number": "757-967-9251",
            "fax_number": "757-967-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LONDON ST",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237042510",
            "telephone_number": "757-967-9251",
            "fax_number": "757-967-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDMARC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "STITZER-BRAME",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "757-967-9251",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4972635",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA-OPTIMA INS.",
            "identifier": "52662",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "001825",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH INS.",
            "identifier": "396402",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christofer Ecklund, PSY.D.
• Nancy E Edenfield, LMFT
• Mia Edgar, MD
• Erica Renee Edge, LCSW
• Kathryn E Edman, AG-ACNP-BC
• John T Edmonds, MD
• Andrew-Anthony Edwards, MD
• Elizabeth Edwards, NNP
• Heather L Edwards, CD(DONA)
• Julien Darryl Edwards, DMD

• Home Health Agency in Portsmouth, VA
• Providers in Portsmouth, 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 Oct 22, 2019; 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.