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EPIC HOME HEALTH SERVICES LLC
Complete NPI Record 1912580440
Home Health in Reston, VA

NPI Status: Active since May 03, 2021

Contact Information

1875 CAMPUS COMMONS DR STE 210
RESTON, VA
ZIP 20191
Phone: (240) 426-6988

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Title or Position
  22. Authorized Official Telephone Number
  23. Healthcare Provider Taxonomy Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Healthcare Provider Taxonomy Code 2
  26. Healthcare Provider Primary Taxonomy Switch 2
  27. Healthcare Provider Taxonomy Code 3
  28. Healthcare Provider Primary Taxonomy Switch 3
  29. Is Organization Subpart
  30. Healthcare Provider Taxonomy Group 2
  31. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1912580440. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1912580440
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
The middle name of the authorized official.
Employer Identification Number EIN: UNAVAIL
The title or position of the authorized official.
The 10-position telephone number of the authorized official.
Provider First Line Business Mailing Address: 3201 ORIENT FISHTAIL RD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: LAUREL
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 207242931
The middle name of the provider, if the provider is an individual.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 2404266988
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 1875 CAMPUS COMMONS DR STE 210
Provider Business Practice Location Address City Name: RESTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: VA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 201911567
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 2404266988
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 5/3/2021
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/4/2024
The date that a record was last updated or changed.
Authorized Official Last Name: MBAYO
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: MUNDE
The first name of the authorized official.
Authorized Official Title or Position: ADMINISTRATOR
The title or position of the authorized official.
Authorized Official Telephone Number: 5712495819
The telephone number associated with the location address of the provider being identified.
Healthcare Provider Taxonomy Code 1: 251E00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Healthcare Provider Taxonomy Code 2: 3747P1801X
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 385H00000X
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Primary Taxonomy Switch 3: N
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP
NPI Certification Date: 11/4/2024