NPIMap

Organization Active NPI

Life Choice Hospice of Southern Massachusetts LLC

Doing business as Compassus - Sosuthern Massachusetts

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • North Andover, MA
National Provider Identifier
1073138640
Registry record updated Jun 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
LIFE CHOICE HOSPICE OF SOUTHERN MASSACHUSETTS LLC
Doing business as
Compassus - Sosuthern Massachusetts
Practice address
790 Turnpike St Ste 202
North Andover, MA 01845-6138
Phone
(978) 777-8222
Fax
(978) 777-8224
NPI assigned
Jun 10, 2020
Last updated
Jun 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2020

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X NU Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU

Addresses

Primary practice location

790 Turnpike St Ste 202
North Andover, MA 01845-6138

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022

Other names 1

  • Compassus - Sosuthern Massachusetts Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607001367 MA Part B Supplier - Clinic/Group Practice 3971741844 Receives reassigned benefits from 7 practitioners
Practice locations: North Andover, MA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Allegiance Hospice Care of Southeastern Massachusetts LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

123 Waterhouse Rd
#5
Bourne, MA 02532
Phone (508) 743-0203

790 Turnpike St
Ste 202
North Andover, MA 01845
Phone (978) 777-8222

790 Turnpike St
Ste 302
North Andover, MA 01845
Phone (978) 655-7782

100 River Ridge Dr
Ste 302
Norwood, MA 02062
Phone (781) 501-1597

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591747200000",
    "number": "1073138640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "615-377-7022",
            "fax_number": "615-373-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 TURNPIKE ST STE 202",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456138",
            "telephone_number": "978-777-8222",
            "fax_number": "978-777-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE CHOICE HOSPICE OF SOUTHERN MASSACHUSETTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus - Sosuthern Massachusetts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.