SOUTHERNCARE INC (NPI# 1508804279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508804279 |
| Entity Type | Organization |
| Organization Name | SOUTHERNCARE INC |
| Other Organization Name | SOUTHERNCARE PETERSBURG |
| Practice Address |
3321 South Crater Road Petersburg VA 23805 |
| Mailing Address |
2204 Lakeshore Dr Suite 475 Birmingham AL 35209-6705 |
| Practice Telephone | 8047325220 |
| Practice Fax Number | 8047325227 |
| Mailing Telephone | 2058684400 |
| Mailing Fax Number | 2058684401 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2009-04-22 |
| Authorized Official Name | MR. MICHAEL J PARSONS (CEO PRESIDENT) |
| Authorized Official Telephone | 2058684400 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | VA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010298954 | 05 | |
| VA | STATE LICENSE NUMBER | HSP-06127 | 01 |
| Other Name | Type Code |
|---|---|
| SouthernCare Petersburg | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134150931 | Southerncare Inc | Hospice Care, Community Based | 68853550 Hulen Street, Ste B, Fort Worth, TX 76107-6885 | 2006-07-06 |
| 1366483091 | Southerncare Inc | Hospice Care, Community Based | 2360 Pepperell Pkwy, Opelika, AL 36801-6240 | 2006-06-10 |
| 1699715474 | Southerncare Inc | Hospice Care, Community Based | 220 N Plaza Blvd, Chillicothe, OH 45601-1787 | 2006-06-08 |
| 1134169642 | Southerncare Inc | Hospice Care, Community Based | 4781 South Main Street, Stafford, TX 77477-4723 | 2006-06-07 |
| 1801835608 | Southerncare Inc | Hospice Care, Community Based | 27 Maple Ridge Dr, Ste A, Cartersville, GA 30121-2293 | 2006-06-06 |
| 1487693354 | Southerncare Inc | Hospice Care, Community Based | 8560 Holcomb Bridge Rd, Ste 110, Alpharetta, GA 30022-5988 | 2006-06-06 |
| 1194763573 | Southerncare Inc | Hospice Care, Community Based | 2780 Commerce Dr, Suite 100, Middletown, PA 17057-3245 | 2006-06-04 |
| 1558309930 | Southerncare Inc | Hospice Care, Community Based | 3100 Cottage Hill Rd, Ste 112 & 117, Mobile, AL 36606-2913 | 2006-06-04 |
| 1003854522 | Southerncare Inc | Hospice Care, Community Based | 110 N Jerry Clower Blvd, Ste B, Yazoo City, MS 39194-8669 | 2006-06-04 |
| 1518905777 | Southerncare Inc | Hospice Care, Community Based | 2258 Schultz Rd, Ste 116 & 118, St Louis, MO 63146-3424 | 2006-06-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SouthernCare Inc. | 655 Brawley School Road, Ste 200, Mooresville, North Carolina 28117 |
| North Carolina Corporations | Southerncare Inc. | 2 South Salisbury Street, Raleigh, NC 27601 |
| Street Address |
3321 SOUTH CRATER ROAD |
| City | PETERSBURG |
| State | VA |
| Zip Code | 23805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134690647 | Miles Viant | Occupational Therapist | 287 E Blvd, Petersburg, VA 23805 | 2018-12-10 |
| 1245756964 | Dexter Shabazz Lett | Registered Nurse | 10543 S. Crater Rd, S. Prince George, VA 23805 | 2017-08-15 |
| 1891145876 | Taylor Enhanced Living | Counselor | 105 Holly Hill Dive, Suite A, Petersburg, VA 23805 | 2016-06-21 |
| 1700255205 | Ina Thompson | Counselor | 272 Medical Park Boulevard, Petersburg, VA 23805 | 2015-09-15 |
| 1932582541 | Valeria Edda Madrid Malo Bohorquez | Internal Medicine | 50 Medical Park Blvd Ste C, Petersburg, VA 23805 | 2015-06-30 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1225417082 | Paladin Dermatology LLC | Nurse Practitioner | 44 A& B Medical Park Blvd, Petersburg, VA 23805 | 2015-05-27 |
| 1245652544 | Family Services Inc. | Health Maintenance Organization | 1045 Gustavo Lane, Petersburg, VA 23805 | 2014-01-06 |
| 1619268075 | Charlene Belangia | Massage Therapist | 3323 S. Crater Rd, Suite B, Petersburg, VA 23805 | 2011-04-20 |
| 1760709638 | Caresouth Hha Holdings of Virginia, LLC | Home Health | 34 Medical Park Boulevard, Suite G-h, Petersburg, VA 23805 | 2010-04-30 |
| Find all providers in zip 23805 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962407700 | Crater Community Hospice Inc | Hospice Care, Community Based | 3916 S Crater Rd, Petersburg, VA 23805-9202 | 2005-06-17 |
| 1174721963 | Commission On Aging Family Services | Hospice Care, Community Based | 111 Virginia Ave, Petersburg, WV 26847-1713 | 2007-07-03 |
| 1003936220 | Old Dominion Adult Day Care | Hospice Care, Community Based | 2787 S Crater Rd, Suite D, Petersburg, VA 23805-2471 | 2007-03-30 |
| 1730152513 | Grant Memorial Hospital | Hospice Care, Community Based | 1 Hospital Drive, Petersburg, WV 26847 | 2006-02-10 |
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|---|---|---|---|---|
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| 1881293835 | Riverside Health Source LLC | Hospice Care, Community Based | 289 Hospital Rd, Tappahannock, VA 22560-5145 | 2020-10-21 |
| 1699373449 | Affinity Care of Virginia LLC | Hospice Care, Community Based | 714 Thimble Shoals Blvd Ste C, Newport News, VA 23606-2574 | 2020-10-14 |
| 1730786138 | Serenity First, LLC | Hospice Care, Community Based | 4915 Fitzhugh Ave, Richmond, VA 23230-3544 | 2020-10-08 |
| 1477169811 | Advance Care Hospice, LLC | Hospice Care, Community Based | 585 Southlake Blvd Ste A, North Chesterfield, VA 23236-3198 | 2020-09-21 |
| 1689285660 | Va State Transportation LLC | Hospice Care, Community Based | 11079 Quail Whistle Dr, Glen Allen, VA 23059-5200 | 2020-08-12 |
| 1386263499 | Trinity Hospice 1, LLC | Hospice Care, Community Based | 1401 Kempsville Road, Suite A, Unit 1, Chesapeake, VA 23320 | 2020-04-09 |
| 1114550134 | Athc - Hospice, LLC | Hospice Care, Community Based | 1121 Heatherstone Dr, Fredericksburg, VA 22407-4828 | 2020-02-18 |
| 1548893951 | 24/7 We Care, LLC | Hospice Care, Community Based | 900 Granby St, Norfolk, VA 23510-2503 | 2020-02-14 |
| 1548806573 | All-4-one Home Healthcare Services, Inc. | Hospice Care, Community Based | 1629 Salem Rd Ste 101, Virginia Beach, VA 23456-5494 | 2019-11-25 |
| Find all providers with the same taxonomy | ||||
| City | PETERSBURG |
| Zip Code | 23805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.