NPIMap

Organization Active NPI

St. Joseph Hospice of South Alabama, LLC

  • Community Based Hospice Care Agency
  • Mobile, AL
National Provider Identifier
1033558705
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ST. JOSEPH HOSPICE OF SOUTH ALABAMA, LLC
Practice address
23 Midtown Park W Unit B
Mobile, AL 36606-4139
Phone
(251) 675-7555
Fax
(251) 675-1541
NPI assigned
Jun 17, 2013
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Patrick Mitchell
Title
Managing Member
Phone
(225) 368-3181

Owners & managing parties with NPI records 1

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

Facilities with the same owner 33

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

View all 33

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
St Joseph Hospice of South Alabama LLCCCN 011684
Ownership
For-Profit
Certified
Oct 31, 2014
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
01D2084571St Joseph Hospice of South Alabama23 Midtown Park W, Mobile, AL 36606Certificate of waiverJun 29, 2027

Medicare participation

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

Hospice certification: CCN 011684

Legal name
ST. JOSEPH HOSPICE OF SOUTH ALABAMA ,LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 31, 2014
Last certification
Jul 9, 2014
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
in LA
Enrollment address
23 Midtown Park W
Unit B
Mobile, AL 36606-4139

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130910000188 LA Part A Provider - Hospice 1850535071 Practice locations: Mobile, AL

All disclosed owners & managing parties 12

Medicare enrollment files

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

NameRoleSinceShare
Patrick Thomas Mitchell Individual Operational/Managerial ControlManager Mar 6, 2013 100%
PCM Hospice Enterprises LLC Organization, Baton Rouge, LA LLC 5% Or Greater Direct Ownership Interest Nov 10, 2022 98.93%
Kelly Mitchell Individual Other Dec 31, 2022 25.3%
Eleanor Holleman Individual Other May 1, 2019 9.5%
Craig M Dowden Individual Operational/Managerial ControlMedical Director Oct 3, 2022
Catherine Ross Mitchell Individual Other Dec 31, 2022 15.83%
John Holleman Individual Other May 1, 2019 9.5%
PTM 2018 Family Trust Organization, Baton Rouge, LA Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2022 97.94%
Emily Holleman Individual Other Dec 31, 2022 25.3%
Sophie Montgomery Plotniak Individual Operational/Managerial ControlAdministrator Jul 13, 2020
Mark S Crowson Individual 5% Or Greater Direct Ownership Interest Nov 10, 2022 1.07%
Wilton Holleman Individual Other May 1, 2019 9.5%

National Provider Directory

National Provider Directory

Locations

23 Midtown Park W
#B
Mobile, AL 36606
Phone (251) 675-7555

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

23 Midtown Park W Unit B
Mobile, AL 36606-4139

Mailing address

10615 Jefferson Hwy
Baton Rouge, LA 70809-7230
Phone (225) 368-3181

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 25, 2022.

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1033558705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708097230",
            "telephone_number": "225-368-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MIDTOWN PARK W UNIT B",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366064139",
            "telephone_number": "251-675-7555",
            "fax_number": "251-675-1541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HOSPICE OF SOUTH ALABAMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "225-368-3181"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.