NPIMap

Organization Active NPI

Healthaccess, Inc.

Doing business as Vidant Home Health and Hospice

  • Home Health Agency
  • Greenville, NC
National Provider Identifier
1972585800
Registry record updated Oct 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HC1443 Issued in NC
Legal business name
HEALTHACCESS, INC.
Doing business as
Vidant Home Health and Hospice
Practice address
1005 W H Smith Blvd
Greenville, NC 27835-5052
Phone
(252) 847-7830
Fax
(252) 847-7910
NPI assigned
Nov 16, 2005
Last updated
Oct 9, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2014

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

Authorized official

Name
Mr. Travis L Douglass
Title
President
Phone
(252) 847-9168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HC1443 NC Primary

Addresses

Primary practice location

1005 W H Smith Blvd
Greenville, NC 27835-5052

Mailing address

PO Box 8125
Greenville, NC 27835-8125
Phone (252) 847-7830

Other identifiers 2

IdentifierTypeStateIssuer
3407220MedicaidNC
0072QOtherNCBCBS PROVIDER NUMBER

Other names 1

  • Vidant Home Health and Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120411000816 NC Part A Provider - Home Health Agency 5395658322 Practice locations: Greenville, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972585800. Details of each certification follow.

Home health agency certification: CCN 347220

Legal name
HEALTHACCESS, INC.
Doing business as
ECU HEALTH HOME HEALTH AND HOSPICE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Oct 29, 1996
Last certification
Oct 13, 2012
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Aug 18, 1983 in NC
Enrollment address
1005 W H Smith Boulevard
Greenville, NC 27834-5052

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Vidant Home Health and HospiceCCN 347220 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Oct 29, 1996
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
East Carolina Health Serv8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

521 Myers St W
Ahoskie, NC 27910
Phone (252) 332-3392

304 W Granville St
Windsor, NC 27983
Phone (252) 794-2622

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Scottie Simmons Individual W-2 Managing EmployeeDirector Business Operations Oct 1, 2002
University Health Systems of Eastern Carolina, Inc. Organization, Greenville, NC Non-profit Other Nov 24, 1998 100%
Daniel Drake Individual Corporate OfficerPresident Jul 8, 2018
Michael R Waldrum Individual Corporate OfficerCeo Jun 1, 2015

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 23

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412812800000",
    "number": "1972585800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8125",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278358125",
            "telephone_number": "252-847-7830",
            "fax_number": "252-847-7910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 W H SMITH BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278355052",
            "telephone_number": "252-847-7830",
            "fax_number": "252-847-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHACCESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2014-10-09",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-847-9168",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "HC1443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3407220",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "0072Q",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vidant Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.