NPIMap

Organization Active NPI

Affinis Hospice, LLC

Doing business as Affinis Hospice

  • Community Based Hospice Care Agency
  • Gainesville, GA
National Provider Identifier
1184904435
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
069-036-H Issued in GA
Legal business name
AFFINIS HOSPICE, LLC
Doing business as
Affinis Hospice
Practice address
2565 Thompson Bridge Rd
Suite 201
Gainesville, GA 30501-1723
Phone
(678) 989-0981
Fax
(678) 989-0982
NPI assigned
Aug 18, 2011
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Mrs. Sarah A Thompson, RN, CHPN
Title
Vice President of Operations
Phone
(912) 538-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 069-036-H GA Primary

Addresses

Primary practice location

2565 Thompson Bridge Rd
Suite 201
Gainesville, GA 30501-1723

Mailing address

806 Maple Dr
Vidalia, GA 30474-7208
Phone (912) 538-8000

Other names 1

  • Affinis Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111027000730 GA Part A Provider - Hospice 1759579253 Practice locations: Gainesville, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184904435. Details of each certification follow.

Hospice certification: CCN 111719

Legal name
AFFINIS HOSPICE, LLC
Doing business as
AFFINIS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 5, 2012
Last certification
Mar 31, 2021
Ownership / control type
Non-Profit - Other
Organization structure
LLCNon-profit
Incorporated
Jan 4, 2012 in GA
Enrollment address
2565 Thompson Bridge Road
Suite 201
Gainesville, GA 30501-1723

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
Affinis Hospice, LLC- GainesvilleCCN 111719 · All quality measures
Ownership
Non-Profit
Certified
Jan 5, 2012
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
11D2031380Affinis Hospice, LLC2565 Thompson Bridge Road, Suite 201, Gainesville, GA 30501Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Affinis Hospice11 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 1

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

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Home and Community Services Inc Organization, Gray, GA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2021 100%
Dave a Ringer Individual Operational/Managerial ControlMedical Director Jul 1, 2025 100%
Tanya Seabolt Individual Corporate OfficerAdministrator Feb 1, 2024 100%
W-2 Managing EmployeeAdministrator Feb 1, 2024 100%
Sarah a Thompson Individual Corporate DirectorDirector of Operations Feb 14, 2010 50%
Operational/Managerial ControlDirector of Operations Feb 14, 2010 50%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1184904435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747208",
            "telephone_number": "912-538-8000",
            "fax_number": "912-538-0467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2565 THOMPSON BRIDGE RD",
            "address_2": "SUITE 201",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011723",
            "telephone_number": "678-989-0981",
            "fax_number": "678-989-0982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINIS HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "912-538-8000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "069-036-H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinis Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Affinis Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.