NPIMap

Organization Active NPI

Vistacare USA, LLC

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Greenville, SC
National Provider Identifier
1013962034
Registry record updated Jul 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VISTACARE USA, LLC
Doing business as
Gentiva
Practice address
15 Brendan Way
Suite #100
Greenville, SC 29615-3562
Phone
(864) 297-3164
NPI assigned
May 25, 2006
Last updated
Jul 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2024

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

Authorized official

Name
Ms. Janet Combs
Title
VP of Licensure
Phone
(704) 664-2876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

15 Brendan Way
Suite #100
Greenville, SC 29615-3562

Mailing address

655 Brawley School Rd Ste 200
Mooresville, NC 28117-9601
Phone (704) 664-2876

Other practice location 1

127 Straight Dr
Anderson, SC 29625-1523
Phone (864) 305-2370

Other identifiers 2

IdentifierTypeStateIssuer
C53141HCMedicaidSC
HSP036MedicaidSC

Other names 1

  • Gentiva Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050705000118 SC Part A Provider - Hospice 5597663104 Practice locations: Anderson, SC; Greenville, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013962034. Details of each certification follow.

Hospice certification: CCN 421534

Legal name
VISTACARE USA, LLC
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 16, 1997
Last certification
Jul 22, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
15 Brendan Way
Ste 100
Greenville, SC 29615-3562

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 421534 · All quality measures
Ownership
For-Profit
Certified
Jul 16, 1997
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2163084Vistacare USA LLC Dba Gentiva127 Straight Drive, Anderson, SC 29625Certificate of waiverMar 6, 2027

National Provider Directory

National Provider Directory
Tax ID family
Vistacare USA Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

15 Brendan Way
Ste 100
Greenville, SC 29615
Phone (864) 268-0005

Ownership & related parties

All disclosed owners & managing parties 24

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

NameRoleSinceShare
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Kentucky Homecare Parent Inc. Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerGen Counsel and Corporate Secretary Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Michelle Mullinax Individual W-2 Managing EmployeeAdministrator Apr 30, 2018
David Robinson Arnold Individual Corporate OfficerVP and Controller Dec 31, 2021
W-2 Managing EmployeeHome Office Administrator Dec 31, 2021
Odyssey Healthcare Inc. Organization, Louisville, KY For-profit 5% Or Greater Indirect Ownership Interest Mar 6, 2008 100%
Thomas Joseph Dolan Individual Corporate OfficerCfo Nov 30, 2021
Charlotte Midco, LLC Organization, Atlanta, GA LLC 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP Organization, Atlanta, GA 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerCeo and President Apr 27, 2021
Charlotte Buyer, Inc. Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit Operational/Managerial Control Jul 11, 2018
Odyssey Healthcare Holding Company Organization, Louisville, KY For-profit 5% Or Greater Indirect Ownership Interest Mar 6, 2008 100%
Janet L Combs Individual Corporate OfficerVP, Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Vista Hospice Care, LLC Organization, Louisville, KY For-profit 5% Or Greater Direct Ownership Interest Aug 27, 1998 100%
Centerwell Health Services Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Vistacare LLC Organization, Louisville, KY For-profit 5% Or Greater Indirect Ownership Interest Aug 27, 1998 100%
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%

Owners & managing parties with NPI records 38

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 38

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
GentivaHobbs, NM, CCN 321513 Hospice 5% Or Greater Indirect Ownership Interest (100%) Mar 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 196

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 196

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720915200000",
    "number": "1013962034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BRAWLEY SCHOOL RD STE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179601",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BRENDAN WAY",
            "address_2": "SUITE #100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153562",
            "telephone_number": "864-297-3164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "127 Straight Dr",
            "address_purpose": "LOCATION",
            "city": "Anderson",
            "state": "SC",
            "postal_code": "296251523",
            "country_code": "US",
            "telephone_number": "864-305-2370",
            "fax_number": "864-222-1997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISTACARE USA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-664-2876",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C53141HC",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP036",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.