MEDICARE: NOVA CARE WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861337172
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVA CARE WELLNESS

Provider Business Mailing Address
First Line	:	11240 WAPLES MILL RD STE 201
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-6078
Country	:	US
Telephone Number	:	347-668-5413
Fax Number	:

Provider Business Practice Location Address
First Line	:	11240 WAPLES MILL RD STE 201
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-6078
Country	:	US
Telephone Number	:	347-668-5413
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOON KIM
Credential	:
Telephone Number	:	347-668-5413

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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Directions to “NOVA CARE WELLNESS ” Practice Location

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