St Marys Home for Disabled Children

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

30414001 Issued in VA

Legal business name

ST MARYS HOME FOR DISABLED CHILDREN

Practice address

6171 Kempsville Circle
Norfolk, VA 23502-3930

Phone

(757) 622-2208

Fax

(757) 640-0147

NPI assigned

Jun 26, 2006

Last updated

Jun 25, 2008By 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. William C Giermak

Title

Ceo

Phone

(757) 622-2208

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740217918. Details of each certification follow.

• CCN 49G004 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G004

Legal name

ST MARY'S HOME FOR DISABLED CH

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Oct 1, 1982

Last certification

Mar 6, 2025

Beds

100

Ownership / control type

Private (non-profit)

Facility address

6171 Kempsville Circle
Norfolk, VA 23502

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

CLIA laboratory certificates

Tax ID family

The Albero House4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• St Marys Home for Disabled Children

  • Intellectual Disabilities Intermediate Care Facility
  • Virginia Beach, VA
  • NPI 1235051988
  NPD tax ID
• St Marys Home for Disabled Children

  • Intellectual Disabilities Intermediate Care Facility
  • Virginia Beach, VA
  • NPI 1356263016
  NPD tax ID
• The Albero House

  • Intellectual Disabilities Intermediate Care Facility
  • Norfolk, VA
  • NPI 1356775290
  NPD tax ID

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1740217918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6171 KEMPSVILLE CIRCLE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023930",
            "telephone_number": "757-622-2208",
            "fax_number": "757-640-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6171 KEMPSVILLE CIRCLE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235023930",
            "telephone_number": "757-622-2208",
            "fax_number": "757-640-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARYS HOME FOR DISABLED CHILDREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "GIERMAK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "757-622-2208",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "VA",
            "license": "30414001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004966333",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashonda Spruill, ASSISTANT ADMINISTRA
• Robert C Squatrito
• Rohith Srirama, MD
• Natasha Kapoor Sriraman, M.D.
• Judith B St George, NP
• Harvey Sheldon St. Clair, M.D.
• Carl Raphael St. Remy, M.D.
• Laura M Stacey, M.ED., BCBA, LBA
• Savannah B Stacey
• John Leroy Stacy Jr., CSAC, LPC

• Intellectual Disabilities Intermediate Care Facility in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Intellectual Disabilities Intermediate Care Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.