Memory Lane Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MEMORY LANE HOME HEALTH LLC

Practice address

1300 Thornton St Ste 102
Fredericksburg, VA 22401-4654

Phone

(540) 779-0529

Fax

(530) 779-0529

NPI assigned

Jan 29, 2019

Organization subpart

No

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

Authorized official

Name

Jessica Hedges

Title

Administrator

Phone

(540) 779-0529

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548720000000",
    "number": "1811451396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 THORNTON ST STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014654",
            "telephone_number": "540-779-0529",
            "fax_number": "530-779-0529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 THORNTON ST STE 102",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014654",
            "telephone_number": "540-779-0529",
            "fax_number": "530-779-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORY LANE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A",
        "authorized_official_last_name": "HEDGES",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "540-779-0529"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE ORGANIZATION",
            "identifier": "HCO-2038",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari Melendez, NP
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• Sudeep Joseph Menachery, MD
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• Kristen Mendoza, OTR/L
• Kelly J Menefee, MT
• Shelby Elizabeth Menezes, PA

• Home Health Agency in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.