NPIMap

Organization Active NPI

Vistacare USA, LLC

Doing business as Gentiva I

  • Community Based Hospice Care Agency
  • Blue Bell, PA
National Provider Identifier
1164478103
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
VISTACARE USA, LLC
Doing business as
Gentiva I
Practice address
1777 Sentry Pkwy W Ste 110
Blue Bell, PA 19422-2225
Phone
(215) 619-7710
Fax
(215) 619-7740
NPI assigned
May 25, 2006
Last updated
Jan 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Ms. Janet Combs
Title
VP of Licensure
Phone
(704) 664-2876

Specialties & licenses 1

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

Addresses

Primary practice location

1777 Sentry Pkwy W Ste 110
Blue Bell, PA 19422-2225

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 664-2876

Other practice location 1

1210 Northbrook Dr Ste 220
Trevose, PA 19053-2518
Phone (215) 322-5746

Other identifiers 1

IdentifierTypeStateIssuer
100747901MedicaidPA

Other names 1

  • Gentiva I Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050817000304 PA Part A Provider - Hospice 5597663104 Practice locations: Blue Bell, PA; Trevose, PA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1164478103. Details of each certification follow.

Hospice certification: CCN 391622

Legal name
VISTACARE USA, LLC
Doing business as
GENTIVA I
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 30, 1997
Last certification
Jun 14, 2012
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
1777 Sentry Pkwy W
Ste 110
Blue Bell, PA 19422-2225

Other NPIs with the same Medicare PAC ID 10

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Gentiva ICCN 391622 · All quality measures
Ownership
For-Profit
Certified
Jul 30, 1997
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
39D2151692Vistacare USA, LLC D/B/a Gentiva I1777 Sentry Parkway West, Suite 110, Blue Bell, PA 19422Certificate of waiverJul 24, 2028

National Provider Directory

National Provider Directory
Tax ID family
Vistacare USA Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1210 Northbrook Dr
Ste 220
Trevose, PA 19053
Phone (215) 322-5746

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Kentucky Homecare Parent Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerExecutive VP and General Counsel Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
David Robinson Arnold Individual Corporate OfficerVP and Controller Dec 31, 2021
W-2 Managing EmployeeHome Office Administrator Dec 31, 2021
Odyssey Healthcare Inc. Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Mar 6, 2008 100%
Thomas Joseph Dolan Individual Corporate OfficerChief Financial Officer Nov 30, 2021
Michelle a Scannapieco Individual Contracted Managing EmployeeMD; Jun 1, 2020
Charlotte Midco, LLC Organization, Atlanta, GA LLC 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP Organization, Atlanta, GA 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerChief Executive Officer / President Apr 27, 2021
Amanda Bradley Individual W-2 Managing EmployeeAd; Feb 10, 2025
Charlotte Buyer, Inc. Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit Operational/Managerial Control Jul 11, 2018
Odyssey Healthcare Holding Company Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Mar 6, 2008 100%
Janet L Combs Individual Corporate OfficerVP of Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Vista Hospice Care, LLC Organization, Atlanta, GA For-profit 5% Or Greater Direct Ownership Interest Aug 27, 1998 100%
Centerwell Health Services Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Vistacare LLC Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Aug 27, 1998 100%
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%

Owners & managing parties with NPI records 39

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 39

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
GentivaHobbs, NM, CCN 321513 Hospice 5% Or Greater Indirect Ownership Interest (100%) Mar 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 196

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

View all 196

Practitioners & affiliated clinicians

Affiliated clinicians 17

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1164478103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 SENTRY PKWY W STE 110",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "194222225",
            "telephone_number": "215-619-7710",
            "fax_number": "215-619-7740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 Northbrook Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Trevose",
            "state": "PA",
            "postal_code": "190532518",
            "country_code": "US",
            "telephone_number": "215-322-5746",
            "fax_number": "215-364-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VISTACARE USA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-664-2876",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100747901",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Bell, PA

Sources for this page

Verify at the official NPI Registry.