NPIMap

Organization Active NPI

Adventist Home Health Services Inc

  • Home Health Agency
  • Silver Spring, MD
National Provider Identifier
1598826448
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HH7032 Issued in MD
Legal business name
ADVENTIST HOME HEALTH SERVICES INC
Practice address
12041 Bournefield Way
Ste B
Silver Spring, MD 20904-7907
Phone
(301) 592-4400
Fax
(301) 592-4450
NPI assigned
Dec 13, 2006
Last updated
Jul 22, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Mr. Keith Dominic Ballenger
Title
Vice President
Phone
(301) 592-4409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HH7032 MD Primary

Addresses

Primary practice location

12041 Bournefield Way
Ste B
Silver Spring, MD 20904-7907

Mailing address

12041 Bournefield Way
Ste B
Silver Spring, MD 20904-7907
Phone (301) 592-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060419000786 MD Part A Provider - Home Health Agency 7810949229 Practice locations: Silver Spring, MD; Fort Washington, MD
O20190711002517 DC Part B Supplier - Clinic/Group Practice 7810949229 Receives reassigned benefits from 1 practitioner
Practice locations: Gaithersburg, MD; Silver Spring, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598826448. Details of each certification follow.

Home health agency certification: CCN 217032A

Legal name
ADVENTIST HOME HEALTH SERVICES INC
Doing business as
ADVENTIST HOME HEALTH
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1996 in MD
Enrollment address
12041 Bournefield Way B
Silver Spring, MD 20904-7908

Care Compare: Home health agency

Medicare Care Compare
Listed as
Adventist Home Health Services, Inc.CCN 217032
Overall star rating
4.5 of 5
Ownership
Non-Profit
Certified
Jan 3, 1974
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address. The facility is not in the current Medicare enrollment files, which can mean its Medicare enrollment has ended (or, for VA and military hospitals, that it does not enroll).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0702444Adventist Home Health12041 Bournefield Way Ste B, Silver Spring, MD 20904Certificate of waiverAug 12, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6856 Eastern Ave NW
Ste 210
Washington, DC 20012
Phone (202) 726-4882

820 W Diamond Ave
Ste 100
Gaithersburg, MD 20878
Phone (301) 592-4400

1801 Research Blvd
Rockville, MD 20850
Phone (301) 279-6123

2 Research Pl
Ste 103
Rockville, MD 20850
Phone (301) 592-4770

9711 Medical Center Dr
Ste 111
Rockville, MD 20850
Phone (301) 592-4400

3720 Leonardtown Rd
Waldorf, MD 20601
Phone (301) 592-4777

6 Industrial Park Dr
Waldorf, MD 20602
Phone (301) 870-7222

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Kristen Pulio Individual Corporate OfficerSVP & Cfo Nov 1, 2021
W-2 Managing EmployeeSVP & Cfo Nov 1, 2021
Terry Lee Forde Individual Corporate OfficerCeo May 14, 2011
Corporate DirectorCeo May 14, 2011
Operational/Managerial ControlCeo May 14, 2011
James Gyeong-Jin Lee Individual Corporate OfficerVP and Cfo Jan 1, 2005
Operational/Managerial ControlSen VP & Cheif Fin Off, Adv Heal Jan 1, 2005
Adventist Healthcare, Inc. Organization, Gaithersburg, MD Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 1973 100%
Operational/Managerial Control Oct 1, 1973 100%
John Sackett Individual Corporate OfficerCoo Jun 1, 2015
Corporate DirectorCoo Jun 1, 2015
Operational/Managerial ControlCoo Jun 1, 2015
Susan Glover Individual Corporate DirectorVP Cqo Jan 1, 2008
Operational/Managerial ControlVP Cqo Jan 1, 2008
Lynette Godhard Individual Operational/Managerial ControlDirector of Chief Operating Off May 6, 2006
Marta Brito Perez Individual Corporate DirectorSr. VP Post Acute Services Aug 1, 2017
Operational/Managerial ControlSr. VP Post Acute Services Aug 1, 2017

Owners & managing parties with NPI records 3

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

  • Adventist Healthcare, Inc

    dba Capital Choice Pathology Laboratory

    • Anatomic Pathology & Clinical Pathology Physician
    • Silver Spring, MD
    • NPI 1033123880

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Adventist Healthcare, Inc.

    dba Adventist HealthCare White Oak Medical Center

    • General Acute Care Hospital
    • Silver Spring, MD
    • NPI 1487650024

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership
  • Adventist Healthcare, Inc.

    dba Adventist HealthCare Shady Grove Medical Center

    • General Acute Care Hospital
    • Rockville, MD
    • NPI 1568468221

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

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.

Affiliated clinicians 386

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

View all 386

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1598826448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12041 BOURNEFIELD WAY",
            "address_2": "STE B",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047907",
            "telephone_number": "301-592-4400",
            "fax_number": "301-592-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12041 BOURNEFIELD WAY",
            "address_2": "STE B",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209047907",
            "telephone_number": "301-592-4400",
            "fax_number": "301-592-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "BALLENGER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "DOMINIC",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "301-592-4409",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "HH7032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.