NPIMap

Organization Active NPI

Sentara Enterprises

Doing business as Sentara Hospice

  • Community Based Hospice Care Agency
  • South Boston, VA
National Provider Identifier
1194365049
Registry record updated Feb 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SENTARA ENTERPRISES
Doing business as
Sentara Hospice
Practice address
2200 Wilborn Ave
South Boston, VA 24592-1645
Phone
(434) 517-3339
NPI assigned
Jan 8, 2020
Last updated
Feb 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2020

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

Authorized official

Name
Teresa L Edwards
Title
President
Phone
(757) 553-3000

Specialties & licenses 1

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

Addresses

Primary practice location

2200 Wilborn Ave
South Boston, VA 24592-1645

Mailing address

535 Independence Pkwy Ste 200
Chesapeake, VA 23320-5176
Phone (757) 553-3000

Other names 1

  • Sentara Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200413002587 VA Part A Provider - Hospice 6608770151 Practice locations: South Boston, VA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194365049. Details of each certification follow.

Hospice certification: CCN 491555

Legal name
SENTARA ENTERPRISES
Doing business as
SENTARA HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 20, 2000
Last certification
Nov 15, 2012
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Oct 26, 1982 in VA
Enrollment address
2200 Wilborn Ave
South Boston, VA 24592-1645

Other NPIs with the same Medicare PAC ID 16

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 16

Care Compare: Hospice

Medicare Care Compare
Listed as
Sentara Hospice (Halifax)CCN 491555 · All quality measures
Ownership
Other
Certified
Apr 20, 2000
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Sentara Enterprises Amb19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

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
Melinda Hancock Individual Corporate OfficerTreasurer Dec 30, 2024
Corporate DirectorBod - Evp & Cfo Dec 30, 2024
Dennis Matheis Individual Corporate DirectorCeo Sep 1, 2022
Angela H Morris Individual W-2 Managing EmployeeAd; Jul 10, 2023
Keren R Slack-Ellis Individual W-2 Managing EmployeeDirector of Hospice May 5, 2022
Eric Conley Individual Corporate OfficerChair Aug 27, 2024
Corporate DirectorBod-Evp-Acute-Post Acute Aug 27, 2024
Earl Barnes Individual Corporate OfficerSecretary Jun 6, 2022
Katrina M Melton Individual Corporate OfficerPresident Dec 30, 2024
Corporate DirectorBod-Gov Body Member-VP Post Acute Dec 30, 2024
Sunil Patel Individual Corporate DirectorGoverning Body Member Dec 30, 2024
David Lee Parks Individual Corporate DirectorGoverning Body Member Jun 1, 2025
W-2 Managing EmployeeMD; Jun 1, 2025
Sentara Health Organization, Norfolk, VA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 26, 2013 100%

Facilities with the same owner 30

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

View all 30

Change-of-ownership history 1

DateEventCounterparty
Feb 2, 2020 Change of OwnershipThis provider was the buyer Sentara Halifax Hospice and Palliative CareCCN 491555, VA, NPI 1013977933

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582761600000",
    "number": "1194365049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 INDEPENDENCE PKWY STE 200",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205176",
            "telephone_number": "757-553-3000",
            "fax_number": "757-382-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WILBORN AVE",
            "city": "SOUTH BOSTON",
            "state": "VA",
            "postal_code": "245921645",
            "telephone_number": "434-517-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENTARA ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-553-3000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sentara Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sentara Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Boston, VA

Sources for this page

Verify at the official NPI Registry.