Active NPI
Genoveva Ienco
- Nurse's Aide
- Stafford, VA
National Provider Identifier
1891344362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 1401181239
- Practice address
- 3 Crosswood PL
Stafford, VA 22554-7839 - Phone
- (703) 899-8997
- NPI assigned
- Sep 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 1401181239 | VA | Primary |
Addresses
Primary practice location
3 Crosswood PL
Stafford, VA 22554-7839
Mailing address
524 Garrisonville Rd
P.O. Box 151
Garrisonville, VA 22463
Phone (703) 899-8997
Other names 1
- Mrs. Genoveva Gomez-Iraheta
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1401181239 | VA | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vida in Home Care LLC | Current | Accepting new patients |
Locations
524 Garrisonville Rd
Unit 151
Garrisonville, VA 22463
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Stafford, VA
- NPI 1932814308
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665273600000",
"number": "1891344362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "524 GARRISONVILLE RD",
"address_2": "P.O. BOX 151",
"city": "GARRISONVILLE",
"state": "VA",
"postal_code": "22463",
"telephone_number": "703-899-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 CROSSWOOD PL",
"city": "STAFFORD",
"state": "VA",
"postal_code": "225547839",
"telephone_number": "703-899-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IENCO",
"first_name": "GENOVEVA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-08",
"last_updated": "2022-10-09",
"certification_date": "2022-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "VA",
"license": "1401181239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GENOVEVA",
"last_name": "GOMEZ-IRAHETA",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Stafford, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.