NPIMap

Organization Active NPI

Adventa Hospice, Inc.

Doing business as Amedisys Hospice of Blue Ridge

  • Community Based Hospice Care Agency
  • Blue Ridge, GA
National Provider Identifier
1184834749
Registry record updated Oct 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ADVENTA HOSPICE, INC.
Doing business as
Amedisys Hospice of Blue Ridge
Practice address
140 Progress Circle
Suite 3
Blue Ridge, GA 30513-4474
Phone
(706) 632-3940
Fax
(706) 632-3948
NPI assigned
May 23, 2007
Last updated
Oct 22, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVENTA HOSPICE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2009

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

Authorized official

Name
Mr. William Borne
Title
Ceo
Phone
(225) 292-2031

Specialties & licenses 1

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

Addresses

Primary practice location

140 Progress Circle
Suite 3
Blue Ridge, GA 30513-4474

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 298-3548

Other identifiers 1

IdentifierTypeStateIssuer
000921962BMedicaidGA

Other names 1

  • Amedisys Hospice of Blue Ridge Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060606000245 GA Part A Provider - Hospice 9638168735 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dalton, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184834749. Details of each certification follow.

Hospice certification: CCN 111643

Legal name
ADVENTA HOSPICE, L.L.C.
Doing business as
AMEDISYS HOSPICE OF DALTON
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 18, 2006
Last certification
Mar 18, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Nov 18, 2002 in GA
Enrollment address
1510 N Thornton Ave
Ste 200
Dalton, GA 30720-8517

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Amedisys Hospice of DaltonCCN 111643 · All quality measures
Ownership
For-Profit
Certified
Dec 18, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Adventa Hospice Inc8 organizations share this tax ID, including this one
Part of
Adventa Hospice Inc

Other organizations with this tax ID 7

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

Locations

140 Progress Cir
Ste 3
Blue Ridge, GA 30513
Phone (706) 632-3940

1510 N Thornton Ave
Ste 200
Dalton, GA 30720
Phone (706) 259-2518

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 14, 2025 100%
Marcus Donavon Macip Individual Corporate DirectorVice President Jan 1, 2026
Kimberly Seymour Individual Corporate OfficerCfo-LHC Group Jan 1, 2026
Bridget R Kaigler Individual W-2 Managing Employee Apr 15, 2022
Operational/Managerial ControlSr. Director, Tax Apr 15, 2022
Amedisys Inc Organization, Baton Rouge, LA Corporation, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Dec 19, 2006 100%
Peter Psenicka Individual W-2 Managing EmployeeAdministrator Apr 3, 2023
Operational/Managerial ControlAdministrator Apr 3, 2023
Kristina J Braud Individual W-2 Managing Employee Apr 15, 2022
Operational/Managerial ControlRegulatory Manager Apr 15, 2022
Jeanne Louise Shingleton Individual Corporate OfficerSecretary Jan 1, 2026
Amedisys Holding LLC Organization, Baton Rouge, LA LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 19, 2006 100%
Joshua Lee Proffitt Individual Corporate OfficerPresident Jan 1, 2026

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1184834749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-298-3548",
            "fax_number": "225-295-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PROGRESS CIRCLE",
            "address_2": "SUITE 3",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134474",
            "telephone_number": "706-632-3940",
            "fax_number": "706-632-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTA HOSPICE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVENTA HOSPICE, INC.",
        "enumeration_date": "2007-05-23",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "BORNE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-292-2031",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000921962B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amedisys Hospice of Blue Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blue Ridge, GA

Sources for this page

Verify at the official NPI Registry.