NPIMap

Organization Active NPI

Kidscare Home Health of Virginia LLC

Doing business as KidsCare Home Health of Virginia

  • Home Health Agency
  • Reston, VA
National Provider Identifier
1841869096
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
KIDSCARE HOME HEALTH OF VIRGINIA LLC
Doing business as
KidsCare Home Health of Virginia
Practice address
1768 Business Center Dr Ste 330
Reston, VA 20190-5349
Phone
(866) 919-3240
NPI assigned
Jun 22, 2021
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Kelly Kaskavage
Title
Director of Compliance
Phone
(214) 575-2999

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Nursing Care Agency 251J00000X

Addresses

Primary practice location

1768 Business Center Dr Ste 330
Reston, VA 20190-5349

Mailing address

4201 Spring Valley Rd Ste 600
Dallas, TX 75244-3631
Phone (866) 919-3240

Other names 1

  • KidsCare Home Health of Virginia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220803003781 VA Part A Provider - Home Health Agency 3779965918 Practice locations: Reston, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841869096. Details of each certification follow.

Home health agency certification: CCN 497793

Legal name
KIDSCARE HOME HEALTH OF VIRGINIA LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 9, 2022
Last certification
Sep 9, 2022
Organization structure
LLCProprietary
Incorporated
Jun 21, 2021 in TX
Enrollment address
1768 Business Center Dr
Ste 330
Reston, VA 20190-4882

Care Compare: Home health agency

Medicare Care Compare
Listed as
Kidscare Home Health of VirginiaCCN 497793 · All quality measures
Ownership
-
Certified
Sep 9, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1768 Business Center Dr
Ste 330
Reston, VA 20190
Phone (703) 679-7837

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
TMS-CJ Holdings, LLC Organization, Dallas, TX LLC 5% Or Greater Direct Ownership Interest Jun 21, 2021 100%
Cortney Baker Individual 5% Or Greater Indirect Ownership InterestCeo Jun 21, 2021 100%
Corporate OfficerCeo Jun 21, 2021 100%
Corporate DirectorBoard Chair Jun 21, 2021 100%
W-2 Managing EmployeeCeo Jun 21, 2022 100%

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 12

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": "1624320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1841869096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SPRING VALLEY RD STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752443631",
            "telephone_number": "866-919-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1768 BUSINESS CENTER DR STE 330",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201905349",
            "telephone_number": "866-919-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSCARE HOME HEALTH OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-22",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "KASKAVAGE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE",
        "authorized_official_telephone_number": "214-575-2999"
    },
    "taxonomies": [
        {
            "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KidsCare Home Health of Virginia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KidsCare Home Health of Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reston, VA

Sources for this page

Verify at the official NPI Registry.