NPIMap

Organization Active NPI

In Home Care, Inc.

  • Home Health Agency
  • Clintwood, VA
National Provider Identifier
1902653439
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IN HOME CARE, INC.
Practice address
5300 Dickenson Hwy
Clintwood, VA 24228-7634
Phone
(276) 328-9340
Fax
(276) 328-9343
NPI assigned
May 2, 2024
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Amy Jackson
Title
Administrator
Phone
(276) 328-9340

Specialties & licenses 1

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

Addresses

Primary practice location

5300 Dickenson Hwy
Clintwood, VA 24228-7634

Mailing address

201 Nottingham Ave
Wise, VA 24293-5612
Phone (276) 328-9340

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111213000074 VA Part A Provider - Home Health Agency 9830219138 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wise, VA; Clintwood, VA; Pennington Gap, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902653439. Details of each certification follow.

Home health agency certification: CCN 497569

Legal name
IN HOME CARE INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jun 27, 2001
Last certification
Oct 22, 2015
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
May 1, 1995 in VA
Enrollment address
201 Nottingham Ave
Wise, VA 24293-5612

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
In Home Care IncCCN 497569 · All quality measures
Overall star rating
2 of 5
Ownership
Proprietary
Certified
Jun 27, 2001
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
In Home Care Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5300 Dickenson Hwy
Clintwood, VA 24228
Phone (276) 328-9340

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Makayla Smith Individual Operational/Managerial ControlClinical Manager Jan 16, 2023
Mildred Bias Individual W-2 Managing EmployeeClinical Manager Apr 1, 2019 100%
Kimberly Robinson Individual W-2 Managing EmployeeClinical Manager May 13, 2024
Michael Whitaker Individual 5% Or Greater Direct Ownership InterestPresident Nov 19, 1999 49%
Corporate OfficerPresident Nov 19, 1999 49%
Karen Smith Individual W-2 Managing EmployeeClinical Manager Aug 1, 2018 100%
Yvonne Whitaker Individual 5% Or Greater Direct Ownership Interest May 4, 1995 51%
Corporate OfficerSecretary May 4, 1995 51%
Corporate Director Oct 8, 1999
W-2 Managing EmployeeAdministrator May 4, 1995 51%
Angel Varner Individual W-2 Managing EmployeeClinical Manager Dec 18, 2023
Amy N Jackson Individual Corporate DirectorAdministrator Sep 1, 2017 100%
Operational/Managerial ControlOperational Manager Sep 1, 2017 100%
Leandra Stanley Individual W-2 Managing Employee Oct 1, 2019 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1714608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1902653439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 NOTTINGHAM AVE",
            "city": "WISE",
            "state": "VA",
            "postal_code": "242935612",
            "telephone_number": "276-328-9340",
            "fax_number": "276-328-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 DICKENSON HWY",
            "city": "CLINTWOOD",
            "state": "VA",
            "postal_code": "242287634",
            "telephone_number": "276-328-9340",
            "fax_number": "276-328-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-02",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "276-328-9340"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clintwood, VA

Sources for this page

Verify at the official NPI Registry.