Healthcare Provider Details

I. General information

NPI: 1124433453
Provider Name (Legal Business Name): KIND-CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2014
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 COPPERMINE RD STE 148
HERNDON VA
20171-6163
US

IV. Provider business mailing address

13800 COPPERMINE RD STE 148
HERNDON VA
20171-6163
US

V. Phone/Fax

Practice location:
  • Phone: 866-769-6746
  • Fax: 703-935-2438
Mailing address:
  • Phone: 866-769-6746
  • Fax: 703-935-2438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberHCO-14594
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SHARMARK MOHAMUD ISMAIL
Title or Position: ALT ADMINISTRATOR
Credential:
Phone: 703-865-9664