Visiting Nurse Group, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

764605 Issued in PA

Legal business name

VISITING NURSE GROUP, INC

Practice address

128 W Girard Ave
Philadelphia, PA 19123-1622

Phone

(215) 829-8888

Fax

(215) 829-8875

NPI assigned

Jul 7, 2005

Last updated

Aug 22, 2020By 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

Mr. Carmelo Pena Guadite, RN, BSN

Title

Administrator

Phone

(215) 829-8888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639176522. Details of each certification follow.

• CCN 397646 Home health agency · Active · Details

Home health agency certification: CCN 397646

Legal name

VISITING NURSE GROUP, INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Sep 12, 1995

Last certification

Nov 16, 2018

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Mar 19, 1986 in PA

Enrollment address

128 W Girard Ave
Philadelphia, PA 19123-1622
HHA Branch

Listed as

Visiting Nurse Group, Inc.CCN 397646 · All quality measures

Ownership

Proprietary

Certified

Sep 12, 1995

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

Locations

All disclosed owners & managing parties 5

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": "1120694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639176522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231622",
            "telephone_number": "215-829-8888",
            "fax_number": "215-829-8875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W GIRARD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191231622",
            "telephone_number": "215-829-8888",
            "fax_number": "215-829-8875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING NURSE GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUADITE",
        "authorized_official_first_name": "CARMELO",
        "authorized_official_middle_name": "PENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-829-8888",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "PA",
            "license": "764605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006767840004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.