Home Health Agency of Georgia, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

033-0340-H Issued in GA

Legal business name

HOME HEALTH AGENCY OF GEORGIA, LLC

Doing business as

Camellia Home Health and Hospice

Practice address

1705 Enterprise Way SE
Suite 102
Marietta, GA 30067-9224

Phone

(678) 218-5745

Fax

(770) 794-8302

NPI assigned

Oct 18, 2010

Last updated

Aug 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wilford A. Payne III

Title

President / Ceo

Phone

(601) 544-2903

Specialties & licenses 2

Addresses

Other names 1

• Camellia Home Health and Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Caresouth HHA Holdings of Gainesville, LLC

  dba Enhabit Hospice

  • Community Based Hospice Care Agency
  • Kennesaw, GA
  • NPI 1649627969

  Sold to, 2016-05-01

  CMS change of ownership

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375833600000",
    "number": "1194035766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 MAYFAIR RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394021464",
            "telephone_number": "601-544-2903",
            "fax_number": "601-264-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 ENTERPRISE WAY SE",
            "address_2": "SUITE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300679224",
            "telephone_number": "678-218-5745",
            "fax_number": "770-794-8302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOME HEALTH AGENCY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2013-08-07",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "WILFORD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT /  CEO",
        "authorized_official_telephone_number": "601-544-2903",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "033 034 10 H",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "033-0340-H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camellia Home Health and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Courtney Holtz, M.D.
• Noel Holtz, M.D.
• Candi Holyfield, FNP-C
• Monica Ellen Holzwarth, M.D
• Home Health Agency of Georgia LLC (Camellia Home Health)
• Caroline Elizabeth Homer, OT R/L
• Brianna Danielle Homsey, DPT
• Kendra Kay Honea, NP
• Aaron Hoodin, MS
• Ashley Hooper, LMSW

• Community Based Hospice Care Agency in Marietta, GA
• Providers in Marietta, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.