Active NPI
Legacy Hospice, LLC
Doing business as Legacy Hospice
- Community Based Hospice Care Agency
- Osceola, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- AR4223
- Legal business name
- LEGACY HOSPICE, LLC
- Doing business as
- Legacy Hospice
- Practice address
- 901 West Keiser Ave
Osceola, AR 72370 - Phone
- (870) 563-9995
- Fax
- (870) 563-8455
- NPI assigned
- Mar 28, 2007
- Last updated
- Oct 12, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Lewis Clark Blair
- Title
- Ceo
- Phone
- (205) 652-6167
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | AR4223 | AR | Primary |
Addresses
Primary practice location
901 West Keiser Ave
Osceola, AR 72370
Mailing address
PO Box 2130
Daphne, AL 36526-2130
Phone (205) 652-6167
Other practice location 1
1714 Falls Blvd N
Wynne, AR 72396-4022
Phone (870) 734-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 154572747 | Medicaid | AR |
Other names 1
- LEGACY HOSPICE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040312001005 | AR | Part A Provider - Hospice | 7416869441 | Practice locations: Osceola, AR; Wynne, AR |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1033238241. Details of each certification follow.
Hospice certification: CCN 041568
- Legal name
- LEGACY HOSPICE, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jun 22, 2004
- Last certification
- Oct 30, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jun 16, 2003 in MO
- Enrollment address
- 901 W Keiser Ave
Osceola, AR 72370-2911
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Legacy Hospice
- Community Based Hospice Care Agency
- Kennett, MO
- NPI 1033238233
7416869441
Care Compare: Hospice
Medicare Care Compare- Listed as
- Legacy Hospice, Inc
- Ownership
- For-Profit
- Certified
- Jun 22, 2004
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Legacy Hospice LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Legacy Hospice
- Community Based Hospice Care Agency
- Kennett, MO
- NPI 1033238233
Locations
1714 Falls Blvd N
Wynne, AR 72396
Phone (870) 734-4000
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| James G Corbin | W-2 Managing Employee | Apr 16, 2020 | |
| Operational/Managerial Control | Apr 6, 2020 | ||
| Clay Jones | W-2 Managing Employee | Jun 20, 2023 | |
| Operational/Managerial Control | Jun 20, 2023 | ||
| Bain Capital Double Impact Fund III, L.P. | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 76.82% |
| Bcdi Legacy Holdings, LP | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 100% |
| LH Holding Company LLC | 5% Or Greater Indirect Ownership Interest | Dec 3, 2019 | 100% |
| Bcip Double Impact II, LP | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 6.27% |
| Kristi Hemphill | W-2 Managing Employee | Apr 1, 2024 | |
| Andrew P Lofaso | W-2 Managing Employee | Jun 20, 2023 | |
| Operational/Managerial Control | Jun 20, 2023 | ||
| Lewis Clark Blair | Corporate Officer | Dec 3, 2019 | |
| Corporate Director | Dec 3, 2019 | ||
| W-2 Managing Employee | Dec 3, 2019 | ||
| Katie N Sanders | W-2 Managing Employee | Dec 18, 2017 | |
| Bcdi Legacy Midco, LLC | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 100% |
| Bcdi Legacy Investor, LP | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 96.71% |
| Bcdi Legacy Topco, LLC | 5% Or Greater Indirect Ownership Interest | Nov 10, 2025 | 100% |
| Legacy Operating Company LLC | 5% Or Greater Direct Ownership Interest | Dec 3, 2019 | 100% |
| Bhavika P Albee | Contracted Managing Employee | Jan 30, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Emergency Medicine Physician
- Pine Bluff, AR
- NPI 1316232648
Contracted Managing Employee
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Legacy Hospice of North Arkansas
- Community Based Hospice Care Agency
- Salem, AR
- NPI 1609995653
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- New Albany, MS
- NPI 1164893343
Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Hattiesburg, MS
- NPI 1518219773
Legacy Operating Company LLC, LH Holding Company LLC
-
- Community Based Hospice Care Agency
- Jackson, MS
- NPI 1326118522
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice
- Community Based Hospice Care Agency
- Kennett, MO
- NPI 1033238233
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
- Community Based Hospice Care Agency
- Demopolis, AL
- NPI 1104860428
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Ripley, MS
- NPI 1386689016
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Grenada, MS
- NPI 1518256460
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Starkville, MS
- NPI 1902105976
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Batesville, MS
- NPI 1306141387
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice of the South
- Community Based Hospice Care Agency
- Selmer, TN
- NPI 1346975471
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
-
dba Legacy Hospice
- Community Based Hospice Care Agency
- Fredericktown, MO
- NPI 1215084876
Bain Capital Double Impact Fund III, L.P., Bcdi Legacy Holdings, LP, Bcdi Legacy Investor, LP, Bcdi Legacy Midco, LLC, Bcdi Legacy Topco, LLC, Bcip Double Impact II, LP, Legacy Operating Company LLC, LH Holding Company LLC
Practitioners & affiliated clinicians
Affiliated clinicians 1
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": "1175040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1760227200000",
"number": "1033238241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2130",
"city": "DAPHNE",
"state": "AL",
"postal_code": "365262130",
"telephone_number": "205-652-6167",
"fax_number": "205-742-0028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 WEST KEISER AVE",
"city": "OSCEOLA",
"state": "AR",
"postal_code": "72370",
"telephone_number": "870-563-9995",
"fax_number": "870-563-8455"
}
],
"practiceLocations": [
{
"address_1": "1714 Falls Blvd N",
"address_purpose": "LOCATION",
"city": "Wynne",
"state": "AR",
"postal_code": "723964022",
"country_code": "US",
"telephone_number": "870-734-4000",
"fax_number": "870-734-4001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LEGACY HOSPICE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-28",
"last_updated": "2025-10-12",
"certification_date": "2025-10-12",
"status": "A",
"authorized_official_last_name": "BLAIR",
"authorized_official_first_name": "LEWIS",
"authorized_official_middle_name": "CLARK",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "205-652-6167",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "AR",
"license": "AR4223",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "154572747",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "LEGACY HOSPICE",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Osceola, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.