Olive Branch Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

OLIVE BRANCH HOSPICE LLC

Practice address

2302 Parklake Dr NE Ste 143
Atlanta, GA 30345-2896

Phone

(470) 395-1000

Fax

(470) 395-1001

NPI assigned

Aug 26, 2019

Organization subpart

No

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

Authorized official

Name

Kimberly Parker

Title

Administrator

Phone

(470) 395-1000

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Hospice certification: CCN 851522

Legal name

OLIVE BRANCH HOSPICE LLC

Doing business as

OLIVE BRANCH HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 7, 2020

Last certification

May 7, 2020

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Incorporated

Sep 5, 2018 in GA

Enrollment address

2302 Parklake Dr NE
# 143
Atlanta, GA 30345-2896

Listed as

Olive Branch Hospice LLCCCN 851522

Ownership

For-Profit

Certified

May 7, 2020

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zuhair Khazisyed Ahmed, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1881913309
  Medicare reassignment NPD

Affiliated clinicians 1

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

• Zuhair Khazisyed Ahmed, M.D.

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1881913309

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1194372995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 SUGARLOAF PKWY STE 400-204",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974344",
            "telephone_number": "404-314-8345",
            "fax_number": "470-385-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 PARKLAKE DR NE STE 143",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303452896",
            "telephone_number": "470-395-1000",
            "fax_number": "470-395-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "470-395-1000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@olivebranch.care",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2302 Parklake Dr NE Ste 143",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303452896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicole S Olds, PAAA
• Noelle Yaeger Oleary, MPH, RD, LD
• Anne Olesen, P.A.
• Jeanine Oliga, MD
• Morcquess Dae-Oni'Lei Oliphant, MEDICAL STUDENT
• Olive Eyecare Inc
• Denise K. Olive, M.S.
• Kathryn Preston Olive, PT
• Priscila J Oliveira Penzenik
• Alessandro Rocha Oliveira, ATC

• Community Based Hospice Care Agency in Atlanta, GA
• Providers in Atlanta, 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 Apr 16, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.