Organization Active NPI

Beverly's Home Health Care Inc

  • Home Health Agency
  • Kew Gardens, NY
National Provider Identifier
1750453130
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
BEVERLY'S HOME HEALTH CARE INC
Practice address
12510 Queens Blvd Ste 5
Kew Gardens, NY 11415-1522
Phone
(718) 459-5592
Fax
(718) 459-6047
NPI assigned
Nov 14, 2006
Last updated
Jan 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Beverly NicholsNPI 1255403242
Title
Director Officer
Phone
(718) 459-5592

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 9569L001 NY
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X
Personal Care AttendantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 3747P1801X
Home Health AideGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 374U00000X

Addresses

Primary practice location

12510 Queens Blvd Ste 5
Kew Gardens, NY 11415-1522

Mailing address

12510 Queens Blvd Ste 5
Kew Gardens, NY 11415-1522
Phone (718) 459-5592

Other identifiers 2

IdentifierTypeStateIssuer
9569L001OtherNYHOME HEALTH CARE AGENCY
01761260MedicaidNY

National Provider Directory

National Provider Directory

Locations

12510 Queens Blvd
Ste 5
Kew Gardens, NY 11415

9812 66th Ave
Rego Park, NY 11374

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1750453130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12510 QUEENS BLVD STE 5",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151522",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12510 QUEENS BLVD STE 5",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151522",
            "telephone_number": "718-459-5592",
            "fax_number": "718-459-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY'S HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "DIRECTOR  OFFICER",
        "authorized_official_telephone_number": "718-459-5592"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "9569L001",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH CARE AGENCY",
            "identifier": "9569L001",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01761260",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.