Hospice Care Corporation
Organization Active NPI Community Based Hospice Care Agency · Arthurdale, WV
NPI 1194722595 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1194722595
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 1289290 (WV)
- Legal business name
- HOSPICE CARE CORPORATION
- Practice address
- 519 G Road
Arthurdale, WV 26520 - Phone
- (304) 864-0884
- NPI assigned
- Jun 30, 2005
- Organization subpart
- No
Authorized official
- Name
- Malene Davis
- Title
- Ceo President
- Phone
- (304) 864-0884
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Member of 1
Practitioners 4
-
Tabitha Rynn Clark, CNP
-
Brenda Ann Mason, RN, FNP-BC
-
Jodi Washington, FNP-C
-
Marian Penelope Thomas, FNP-BC
Affiliated clinicians 23
-
Garrett L Butler, MD
-
Catherine M. Chua, D.O.
-
Zane A Dennison, DO
-
Lisa M Flower, MD
-
Darla Kay Gant, M.D.
-
Jeanette Helen Jackson, D.O.
-
Matthan Jackson, DO
-
Troy Michael Krupica, M.D
-
Alyson Margaret Leo, M.D.
-
Vicky Lynn Mays, D.O.
-
James Namsupak, M.D.
-
Julia E Ramberg, MD
-
Carl Dean Shrader Jr., M.D., PH.D.
-
Thomas M Stevens, DO
-
Mona Ghias, M.D.
Medicare Care Compare: Hospice
- Listed as
- West Virginia Caring
- Ownership
- Non-Profit
- Certified
- Apr 13, 1989
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Hospice certification: CCN 511504
- Legal name
- HOSPICE CARE CORPORATION
- Doing business as
- WV CARING
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 13, 1989
- Last certification
- Jul 15, 2020
- Ownership / control type
- Other
- Organization structure
- Corporation · Non-profit
- Incorporated
- May 17, 1983 in WV
- Enrollment address
- 519 G Rd
Arthurdale, WV 26520-0760
All disclosed owners & managing parties 5
| Name | Role | Since | Share |
|---|---|---|---|
| Sarah M Branham |
Corporate Director | Jan 1, 2019 | |
| Cynthia Miranov |
Corporate Director | Jan 1, 2019 | |
| Rebecca K Larew |
Corporate Officer |
May 1, 1990 | |
| Corporate Director |
Apr 13, 2007 | ||
| Malene J Davis |
Corporate Officer |
Mar 1, 1988 | 100% |
| Corporate Director |
Mar 1, 1988 | 100% | |
| W-2 Managing Employee |
Mar 1, 1988 | 100% | |
| Denise Mead |
Corporate Director | May 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070426000034 | WV | Part a Provider - Hospice | 3274636238 | Practice locations: Fairmont, WV; Morgantown, WV; Grafton, WV; Elkins, WV; Burnsville, WV; Arthurdale, WV |
National Provider Directory
- Tax ID family
- Morgantown Office
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 1289290 | WV | Yes |
Addresses
Primary practice location
519 G Road
Arthurdale, WV 26520
Mailing address
PO Box 760
Arthurdale, WV 26520-0760
Phone (304) 864-0884
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005151001 | Medicaid | WV | |
| 1316081128 | Medicaid | WV |
Other names
- WV Caring
Other providers in Arthurdale, WV
- Tabitha Rynn Clark
- Dawn Conrad
- Timothy Aaron Cordwell
- Hospice Care Corporation
- Hospice Care Corporation
- Richard Allen Larue
- Living Connected Corporation
- Lorraina Dawn McGinnis
All providers in Arthurdale, WV · Community Based Hospice Care Agency in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.