Organization Active NPI

Virginia Health Hospice LLC

  • Community Based Hospice Care Agency
  • Newport News, VA
National Provider Identifier
1619417433
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VIRGINIA HEALTH HOSPICE LLC
Practice address
204 Nat Turner Blvd S
Newport News, VA 23606-2998
Phone
(757) 223-1396
Fax
(757) 223-1380
NPI assigned
Feb 27, 2017
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Mr. Nicole L Boldy
Title
Exec. Vice Pres.
Phone
(757) 599-7422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

204 Nat Turner Blvd S
Newport News, VA 23606-2998

Mailing address

240 Nat Turner Blvd S
Newport News, VA 23606-0020
Phone (757) 599-1326

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171017002758 VA Part A Provider - Hospice 6204102304 Practice locations: Newport News, VA
O20240425001269 VA Part B Supplier - Clinic/Group Practice 6204102304 Receives reassigned benefits from 2 practitioners
Practice locations: Newport News, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619417433. Details of each certification follow.

Hospice certification: CCN 491627

Legal name
VIRGINIA HEALTH HOSPICE LLC
Doing business as
VIRGINIA HEALTH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 26, 2018
Last certification
Jan 26, 2018
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Oct 17, 2016 in VA
Enrollment address
1103 William Styron SQ S
Newport News, VA 23606-2877

Care Compare: Hospice

Medicare Care Compare
Listed as
Virginia Health HospiceCCN 491627 · All quality measures
Ownership
For-Profit
Certified
Jan 26, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1103 William Styron Sq S
Newport News, VA 23606
Phone (757) 223-1396

204 Nat Turner Blvd S
Newport News, VA 23606
Phone (757) 223-1396

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Tryko Nexgen Holdings LLC Organization, Brick, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 16, 2025 56.8%
VA Holdings Group LLC Organization, Brick, NJ Holding company, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 16, 2025 100%
Robert E Walters Individual Contracted Managing EmployeeMD; Sep 16, 2025
Yr Nexgen TR Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 16, 2025 28.4%
SK Nexgen TR Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 16, 2025 14.2%
Mindee Posen Individual Operational/Managerial ControlMedicare Administration Officer Sep 11, 2025
Rsbrmk Holdings LLC Organization, Brick, NJ LLC 5% Or Greater Indirect Ownership Interest Sep 16, 2025 21.8%
NFR 2020 Irrv TR Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 16, 2025 21.8%
Yk Nexgen TR Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 16, 2025 14.2%
Ukr Nexgen LLC Organization, Brick, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 16, 2025 20%
David Dean Crosson Individual Contracted Managing EmployeeDirector Sep 16, 2025
Corporate DirectorDirector Sep 16, 2025
Michelle Keenan Individual Operational/Managerial Control Mar 16, 2026
Uak 2020 Irrv TR Organization, Brick, NJ 5% Or Greater Indirect Ownership Interest Sep 16, 2025 20%
Quinto Nexgen LLC Organization, Brick, NJ LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Sep 16, 2025 78.6%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 76

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

View all 76

Practitioners & affiliated clinicians

Practitioners 6

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 6

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

NPI Registry JSON

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1619417433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236060020",
            "telephone_number": "757-599-1326",
            "fax_number": "757-595-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 NAT TURNER BLVD S",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062998",
            "telephone_number": "757-223-1396",
            "fax_number": "757-223-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGINIA HEALTH HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "BOLDY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXEC. VICE PRES.",
        "authorized_official_telephone_number": "757-599-7422",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.