Organization Active NPI

Trinity Home Care Services LLC

  • Home Health Agency
  • Woodbridge, VA
National Provider Identifier
1770933343
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
TRINITY HOME CARE SERVICES LLC
Practice address
3102 Golansky Blvd Ste 201
Woodbridge, VA 22192-4244
Phone
(571) 398-6736
NPI assigned
Jun 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Chikata Khyne-Sam, RN
Title
Administrator
Phone
(571) 398-6736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

3102 Golansky Blvd Ste 201
Woodbridge, VA 22192-4244

Mailing address

3102 Golansky Blvd Ste 201
Woodbridge, VA 22192-4244

Other identifiers 1

IdentifierTypeStateIssuer
1770933343MedicaidVA

Care Compare: Home health agency

Medicare Care Compare
Listed as
Trinity Home Care Services LLCCCN 497772
Ownership
Proprietary
Certified
Sep 3, 2020
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).

National Provider Directory

National Provider Directory

Locations

3102 Golansky Blvd
Ste 201
Woodbridge, VA 22192
Phone (571) 396-6736

12934 Harbor Dr
Ste 108
Woodbridge, VA 22192

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1770933343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 GOLANSKY BLVD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 GOLANSKY BLVD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924244",
            "telephone_number": "571-398-6736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HOME CARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "KHYNE-SAM",
        "authorized_official_first_name": "CHIKATA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "571-398-6736",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1770933343",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.