NPIMap

Organization Active NPI

Genesis Hospice Care

  • Community Based Hospice Care Agency
  • Indianola, MS
National Provider Identifier
1164593158
Registry record updated Oct 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GENESIS HOSPICE CARE
Practice address
201 Highway 82 W
Indianola, MS 38751-2141
Phone
(662) 887-1274
Fax
(662) 887-7263
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2009

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

Authorized official

Name
Charline Brandon, RN
Title
Ceo
Phone
(662) 846-0100

Specialties & licenses 1

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

Addresses

Primary practice location

201 Highway 82 W
Indianola, MS 38751-2141

Mailing address

PO Box 1888
Cleveland, MS 38732-1888
Phone (662) 846-0100

Other identifiers 1

IdentifierTypeStateIssuer
03485082MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Genesis Hospice Care LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1164593158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1888",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387321888",
            "telephone_number": "662-846-0100",
            "fax_number": "662-846-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HIGHWAY 82 W",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512141",
            "telephone_number": "662-887-1274",
            "fax_number": "662-887-7263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS HOSPICE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "BRANDON",
        "authorized_official_first_name": "CHARLINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-846-0100",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03485082",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianola, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.