Active NPI
Reliance Health and Home Physician Services, Inc.
- Community Based Hospice Care Agency
- Griffin, GA
National Provider Identifier
1043659253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- RELIANCE HEALTH AND HOME PHYSICIAN SERVICES, INC.
- Practice address
- 625 Carver Rd
Griffin, GA 30224-3937 - Phone
- (770) 227-9222
- Fax
- (678) 688-3892
- NPI assigned
- Jun 20, 2013
- 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
- Stephanie Collier
- Title
- Director
- Phone
- (770) 227-9222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
625 Carver Rd
Griffin, GA 30224-3937
Mailing address
625 Carver Rd
Griffin, GA 30224-3937
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | s.collier0520@gmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20131126001617 | GA | Part A Provider - Hospice | 8022244888 | Practice locations: Griffin, GA |
Hospice certification: CCN 111740
- Legal name
- RELIANCE HEALTH AND HOME PHYSICIAN SERVICES, INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 7, 2014
- Last certification
- Sep 23, 2021
- Ownership / control type
- Government - State
- Organization structure
- Corporation
- Incorporated
- Jul 1, 2016 in GA
- Enrollment address
- 625 Carver Rd
Griffin, GA 30224-3937
Care Compare: Hospice
Medicare Care Compare- Listed as
- Reliance Hospice Care
- Ownership
- For-Profit
- Certified
- Feb 7, 2014
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 5
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 |
|---|---|---|---|
| Ladawnda Castille | Corporate Officer | Jan 1, 2017 | 100% |
| W-2 Managing Employee | Jan 1, 2017 | ||
| Tammie S Steward | Corporate Officer | Jan 1, 2017 | |
| W-2 Managing Employee | Jan 1, 2017 | ||
| Charlisa Rogers | W-2 Managing Employee | May 1, 2013 | 5% |
| Jeffrey Kirksey | 5% Or Greater Direct Ownership Interest | Jan 1, 2017 | 100% |
| 5% Or Greater Indirect Ownership Interest | Jan 1, 2017 | 100% | |
| Gregory Tyler | 5% Or Greater Direct Ownership Interest | Sep 23, 2013 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371686400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1657756800000",
"number": "1043659253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 CARVER RD",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302243937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 CARVER RD",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302243937",
"telephone_number": "770-227-9222",
"fax_number": "678-688-3892"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RELIANCE HEALTH AND HOME PHYSICIAN SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2013-06-20",
"last_updated": "2022-07-14",
"certification_date": "2022-07-14",
"status": "A",
"authorized_official_last_name": "COLLIER",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "770-227-9222"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "s.collier0520@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "625 Carver Rd",
"city": "Griffin",
"state": "GA",
"country_code": "US",
"postal_code": "302243937",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Griffin, GA
- Region IV Department of Family and Children Services
- Regroup Healthcare Services LLC
- Alexander Bruce Reid, MD
- Richard Grantphil Reid, RPH
- Edward J. Reilly, PA
- Reliance Health and Home Physician Services, Inc.
- Reliance Healthcare Services Inc
- Remember Me Community Outreach, Inc.
- D Brian Remington, M.D.
- Luis E Remy, CSA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.