NPIMap

Organization Active NPI

Kanawha Hospice Care, Inc

Doing business as HospiceCare

  • Community Based Hospice Care Agency
  • Charleston, WV
National Provider Identifier
1174556641
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0186990 Issued in WV
Legal business name
KANAWHA HOSPICE CARE, INC
Doing business as
HospiceCare
Wallace Grief and Loss Center
Practice address
1606 Kanawha Blvd W
Charleston, WV 25387-2536
Phone
(304) 768-8523
Fax
(304) 768-6840
NPI assigned
Jul 8, 2006
Last updated
Jan 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
KANAWHA HOSPICE CARE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Authorized official

Name
Mr. Christopher Rawlings
Title
Executive Director
Phone
(304) 768-8523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0186990 WV Primary

Addresses

Primary practice location

1606 Kanawha Blvd W
Charleston, WV 25387-2536

Mailing address

1606 Kanawha Blvd W
Charleston, WV 25387-2536
Phone (304) 768-8523

Other names 2

  • HospiceCare Doing business as
  • Wallace Grief and Loss Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051014000406 WV Part A Provider - Hospice 7416973805 Practice locations: Charleston, WV; South Charleston, WV; Lewisburg, WV; Hurricane, WV
O20180102000674 WV Part B Supplier - Clinic/Group Practice 7416973805 Receives reassigned benefits from 17 practitioners
Practice locations: Charleston, WV; Hurricane, WV; Lewisburg, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174556641. Details of each certification follow.

Hospice certification: CCN 511501

Legal name
KANAWHA HOSPICE CARE, INC
Doing business as
HOSPICE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 10, 1986
Last certification
Jul 22, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 21, 1980 in WV
Enrollment address
1606 Kanawha Blvd W
Charleston, WV 25387-2536

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
Hospicecare, IncCCN 511501 · All quality measures
Ownership
Non-Profit
Certified
Dec 10, 1986
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Kanawha Hospice Care Inc3 organizations share this tax ID, including this one
Part of
Kanawha Hospice Care Inc

Other organizations with this tax ID 2

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

Locations

1143 Dunbar Ave
Dunbar, WV 25064
Phone (304) 766-7336

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Mark O Grigsby Individual Corporate DirectorBoard Member Jan 1, 2020
Richard S Wilbur Individual Corporate DirectorBoard Member Jan 1, 2019
Donteako Wilson Individual Corporate DirectorBoard Member Jan 1, 2021
Miles C Cary Individual Corporate DirectorBoard Member Jan 1, 2021
Dede R Talbott Individual Corporate DirectorBoard Member Jan 1, 2021
Sally N Barton Individual Corporate DirectorBoard Member Jan 1, 2020
Joseph M Price Individual Corporate OfficerBoard Chairman Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020
Richard Doyle Bishoff Individual Corporate DirectorBoard Member Jan 1, 2020
Marion S Jones Individual Corporate DirectorBoard Member Sep 1, 2013
Sharon H Rowe Individual Corporate DirectorBoard Member Jan 1, 2020
Hawthorne Dill Battle Individual Corporate OfficerBoard Secretary Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020
Betty S Ireland Individual Corporate DirectorBoard Member Sep 1, 2012
Michael J Morris Individual W-2 Managing EmployeeDirector of Finance Jun 2, 2002
Twana S Smith Individual Corporate OfficerBoard Treasurer Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020
David a Clayman Individual Corporate DirectorBoard Member Jan 1, 2020
Carol Jean Hartley Individual Corporate DirectorBoard Member Sep 1, 2012
Richard a Kelso Individual Corporate DirectorBoard Member Jan 1, 2020
Shelda a Martin Individual Corporate DirectorBoard Member Jan 1, 2020
Judy D Deegans Individual Corporate DirectorBoard Member Jan 1, 2020
Chris L Rawlings Individual Corporate OfficerCeo Dec 1, 2019
Jacob R Lindsay Individual Corporate OfficerBoard Vice Chair Jan 1, 2020
Corporate DirectorBoard Member Jan 1, 2020

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 17

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 17

Affiliated clinicians 27

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

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642118400000",
    "number": "1174556641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1606 KANAWHA BLVD W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872536",
            "telephone_number": "304-768-8523",
            "fax_number": "304-768-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1606 KANAWHA BLVD W",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872536",
            "telephone_number": "304-768-8523",
            "fax_number": "304-768-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAWHA HOSPICE CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KANAWHA HOSPICE CARE, INC",
        "enumeration_date": "2006-07-08",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A",
        "authorized_official_last_name": "RAWLINGS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "304-768-8523",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WV",
            "license": "0186990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HospiceCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wallace Grief and Loss Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.