NPIMap

Organization Active NPI

PH Health Care Services Inc

  • Community Based Hospice Care Agency
  • Easley, SC
National Provider Identifier
1134491616
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PH HEALTH CARE SERVICES INC
Practice address
4741 Highway 153 Ste B
Easley, SC 29642-9161
Phone
(864) 991-8414
Fax
(864) 991-8404
NPI assigned
Jan 31, 2012
Last updated
Apr 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Authorized official

Name
Ms. Jill D Birmingham, BSW, LNHA
Title
Ceo
Phone
(864) 991-8414

Specialties & licenses 1

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

Addresses

Primary practice location

4741 Highway 153 Ste B
Easley, SC 29642-9161

Mailing address

4741 Highway 153 Ste B
Easley, SC 29642-9161
Phone (864) 991-8414

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120419000696 SC Part A Provider - Hospice 2163683012 Practice locations: Easley, SC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134491616. Details of each certification follow.

Hospice certification: CCN 421614

Legal name
PH HEALTH CARE SERVICES INC
Doing business as
PATRIOT HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 10, 2012
Last certification
Mar 25, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 17, 2011 in SC
Enrollment address
4741 Highway 153
Ste B
Easley, SC 29642-9161

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Patriot HospiceCCN 421614 · All quality measures
Ownership
For-Profit
Certified
Aug 10, 2012
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
PH Health Care Services Inc2 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

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.

NameRoleSinceShare
William S Biggs Individual 5% Or Greater Direct Ownership Interest Nov 17, 2011 40%
Limited Partnership InterestBoard Member Nov 21, 2011 40%
Edward Massey Individual 5% Or Greater Direct Ownership Interest Nov 17, 2011 40%
Limited Partnership InterestPresident Nov 21, 2011 40%
John Twitty Individual 5% Or Greater Direct Ownership Interest Nov 17, 2011 10%
Limited Partnership InterestTreasurer Nov 21, 2011 10%
Heyward Hilliard Individual 5% Or Greater Direct Ownership Interest Nov 17, 2011 10%
Limited Partnership InterestSecetary Nov 21, 2011 10%
Jill D Birmingham Individual Operational/Managerial ControlCeo Mar 1, 2014 100%

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

Affiliated clinicians 7

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": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1134491616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4741 HIGHWAY 153 STE B",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429161",
            "telephone_number": "864-991-8414",
            "fax_number": "864-991-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4741 HIGHWAY 153 STE B",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296429161",
            "telephone_number": "864-991-8414",
            "fax_number": "864-991-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PH HEALTH CARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2024-04-29",
        "certification_date": "2023-08-07",
        "status": "A",
        "authorized_official_last_name": "BIRMINGHAM",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "864-991-8414",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSW, LNHA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easley, SC

Sources for this page

Verify at the official NPI Registry.