NPIMap

Organization Active NPI

Heart of Hospice, LLC

  • Community Based Hospice Care Agency
  • Hattiesburg, MS
National Provider Identifier
1104357177
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
193 Issued in MS
Legal business name
HEART OF HOSPICE, LLC
Practice address
2018 Hardy St Ste 210
Hattiesburg, MS 39401-4975
Phone
(601) 714-1221
Fax
(601) 707-9012
NPI assigned
Mar 22, 2017
Last updated
Dec 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HEART OF HOSPICE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Authorized official

Name
Mr. Joshua L. Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 193 MS Primary

Addresses

Primary practice location

2018 Hardy St Ste 210
Hattiesburg, MS 39401-4975

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other practice location 1

15 Thompson Park Ste B
Hattiesburg, MS 39401-8202
Phone (601) 714-1221

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170726003160 MS Part A Provider - Hospice 6800119298 Practice locations: Hattiesburg, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104357177. Details of each certification follow.

Hospice certification: CCN 251706

Legal name
HEART OF HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 9, 2017
Last certification
Oct 9, 2017
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
May 30, 2014 in SC
Enrollment address
2018 Hardy St
Ste 210
Hattiesburg, MS 39401-4975

Other NPIs with the same Medicare PAC ID 12

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Heart of Hospice, LLC - SouthernCCN 251706 · All quality measures
Ownership
For-Profit
Certified
Oct 9, 2017
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
25D2013423Heart of Hospice, LLC2018 Hardy St Ste 210, Hattiesburg, MS 39401Certificate of waiverSep 19, 2026

National Provider Directory

National Provider Directory
Tax ID family
Heart of Hospice LLC17 organizations share this tax ID, including this one
Part of
Heart of Hospice LLC

Other organizations with this tax ID 16

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

View all 16

Locations

15 Thompson Park
Ste B
Hattiesburg, MS 39401
Phone (601) 714-1221

135 Bounds St
#C
Jackson, MS 39206
Phone (601) 321-8812

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Wenona L Hancock Individual W-2 Managing EmployeeAdministrator/Director of Nursing Sep 1, 2021
Operational/Managerial ControlAdministrator/Director of Nursing Sep 1, 2021
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 100%
Marcus Donavon Macip Individual Corporate OfficerCorporate Secretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerTreasurer Feb 22, 2023
Wendy S Daigle Individual Corporate DirectorDirector, Licensure & Regulatory Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation, Chain home office 5% Or Greater Indirect Ownership Interest Sep 1, 2021 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Sep 1, 2021
Louisiana Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Sep 1, 2021 100%

Facilities with the same owner 44

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

View all 44

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1104357177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 HARDY ST STE 210",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394014975",
            "telephone_number": "601-714-1221",
            "fax_number": "601-707-9012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Thompson Park Ste B",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394018202",
            "country_code": "US",
            "telephone_number": "601-714-1221",
            "fax_number": "601-707-9012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEART OF HOSPICE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEART OF HOSPICE, LLC",
        "enumeration_date": "2017-03-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.