NPIMap

Organization Active NPI

West Virginia Home Health LLC

  • Home Health Agency
  • Martinsburg, WV
National Provider Identifier
1790176840
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
WEST VIRGINIA HOME HEALTH LLC
Practice address
300 Foxcroft Ave
Suite 100B-6
Martinsburg, WV 25401-5341
Phone
(703) 431-3202
Fax
(540) 301-0751
NPI assigned
Feb 11, 2015
Last updated
Jun 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Ms. Betty Sale Corey, R.N.NPI 1821378290
Title
Regional Director
Phone
(703) 431-3202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

300 Foxcroft Ave
Suite 100B-6
Martinsburg, WV 25401-5341

Mailing address

300 Foxcroft Ave
Suite 100B-6
Martinsburg, WV 25401-5341
Phone (703) 431-3202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160830000166 WV Part A Provider - Home Health Agency 2163717190 Practice locations: Martinsburg, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790176840. Details of each certification follow.

Home health agency certification: CCN 517144

Legal name
WEST VIRGINIA HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 14, 2016
Last certification
Oct 14, 2020
Ownership / control type
Proprietary
Organization structure
LLCProprietary
Incorporated
Oct 22, 2014 in WV
Enrollment address
300 Foxcroft Ave
Ste 100B-6
Martinsburg, WV 25401-5341

Care Compare: Home health agency

Medicare Care Compare
Listed as
West Virginia Home Health LLCCCN 517144 · All quality measures
Overall star rating
3 of 5
Ownership
Proprietary
Certified
Dec 14, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D2144727West Virginia Home Health, LLC300 Foxcroft Ave Ste 100B-6, Martinsburg, WV 25401Certificate of waiverSep 18, 2026

National Provider Directory

National Provider Directory

Locations

300 Foxcroft Ave
Ste 100B6
Martinsburg, WV 25401
Phone (304) 240-2698

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Hussein Ibrahim Individual 5% Or Greater Direct Ownership Interest Oct 22, 2014 100%
Corporate OfficerPresident/Ceo Oct 22, 2014
W-2 Managing EmployeePresident/Ceo Oct 22, 2014

Practitioners & affiliated clinicians

Practitioners 2

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 7

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": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1790176840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FOXCROFT AVE",
            "address_2": "SUITE 100B-6",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254015341",
            "telephone_number": "703-431-3202",
            "fax_number": "540-301-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOXCROFT AVE",
            "address_2": "SUITE 100B-6",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254015341",
            "telephone_number": "703-431-3202",
            "fax_number": "540-301-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "COREY",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "SALE",
        "authorized_official_title_or_position": "REGIONAL DIRECTOR",
        "authorized_official_telephone_number": "703-431-3202",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.