NPIMap

Organization Active NPI

Wythe County Community Hospital LLC

  • Community Based Hospice Care Agency
  • Wytheville, VA
National Provider Identifier
1104928514
Registry record updated May 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HSP06121 Issued in VA
Legal business name
WYTHE COUNTY COMMUNITY HOSPITAL LLC
Practice address
600 W Ridge Rd
Hospice of Southwest Virginia
Wytheville, VA 24382
Phone
(276) 228-1710
Fax
(276) 228-1719
NPI assigned
Sep 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2017

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

Authorized official

Name
Victor E. Giovanetti
Title
President
Phone
(615) 920-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HSP06121 VA Primary

Addresses

Primary practice location

600 W Ridge Rd
Hospice of Southwest Virginia
Wytheville, VA 24382

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other identifiers 1

IdentifierTypeStateIssuer
004910141MedicaidVA

Other names 1

  • Hospice of Southwest Virginia Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Tax ID family
Hospice of Southwest Virginia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Jan 1, 2017 Change of OwnershipThis provider was the seller Wythe Hospice Southwest VirginiaCCN 491521, VA, NPI 1023553989

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495670400000",
    "number": "1104928514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W RIDGE RD",
            "address_2": "HOSPICE OF SOUTHWEST VIRGINIA",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "24382",
            "telephone_number": "276-228-1710",
            "fax_number": "276-228-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYTHE COUNTY COMMUNITY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2017-05-25",
        "status": "A",
        "authorized_official_last_name": "GIOVANETTI",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-920-7000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "VA",
            "license": "HSP06121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004910141",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Southwest Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wytheville, VA

Sources for this page

Verify at the official NPI Registry.