Active NPI
Halifax Regional Hospital, Inc.
- Home Health Agency
- South Boston, VA
National Provider Identifier
1972563872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- HALIFAX REGIONAL HOSPITAL, INC.
- Practice address
- 2204 Wilborn Ave
South Boston, VA 24592-1645 - Phone
- (434) 517-3100
- Fax
- (434) 575-6752
- NPI assigned
- Mar 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas Kluge
- Title
- Chief Operating Officer
- Phone
- (434) 517-3100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
2204 Wilborn Ave
South Boston, VA 24592-1645
Mailing address
2204 Wilborn Ave
South Boston, VA 24592-1645
Phone (434) 517-3100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001841 | Other | VA | BCBS HOME HEALTH PROV |
| 4972872 | Medicaid | VA |
Other names 1
- Sentara Halifax Home Health
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider DirectoryOwnership & related parties
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Feb 2, 2020 | Change of Ownership | Sentara Home Care Services |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1423094400000",
"number": "1972563872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 WILBORN AVE",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245921645",
"telephone_number": "434-517-3100",
"fax_number": "434-575-6752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 WILBORN AVE",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245921645",
"telephone_number": "434-517-3100",
"fax_number": "434-575-6752"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HALIFAX REGIONAL HOSPITAL, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-03-24",
"last_updated": "2015-02-05",
"status": "A",
"authorized_official_last_name": "KLUGE",
"authorized_official_first_name": "THOMAS",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "434-517-3100"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS HOME HEALTH PROV",
"identifier": "001841",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4972872",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Sentara Halifax Home Health",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.