Affinis Hospice, LLC
Organization Active NPI Community Based Hospice Care Agency · Albany, GA
NPI 1215188917 · NPPES record last updated Nov 3, 2023
Key facts
- NPI
- 1215188917
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 047-0327-H (GA)
- Legal business name
- AFFINIS HOSPICE, LLC
- Practice address
- 507 N Jefferson St
Albany, GA 31701-2354 - Phone
- (229) 435-2109
- Fax
- (229) 435-0729
- NPI assigned
- Oct 1, 2008
- Organization subpart
- No
Authorized official
- Name
- Mrs. Sarah A. Thompson, RN
- Title
- Director of Operations
- Phone
- (229) 435-2109
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 10
Member of 1
Facilities with the same owner 11
Affiliated clinicians 1
Medicare Care Compare: Hospice
- Listed as
- Affinis Hospice, LLC
- Ownership
- Non-Profit
- Certified
- Mar 5, 2010
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Hospice certification: CCN 111690
- Legal name
- AFFINIS HOSPICE, LLC
- Doing business as
- AFFINIS HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 5, 2010
- Last certification
- Jun 16, 2021
- Ownership / control type
- Non-Profit - Private
- Organization structure
- LLC · Non-profit
- Incorporated
- Dec 9, 2009 in GA
- Enrollment address
- 507 North Jefferson Street
Albany, GA 31701-2354
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Home and Community Services Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2021 | 100% |
| Michael D Satchell |
Contracted Managing Employee |
Apr 1, 2012 | |
| Colleen Dawn Butler |
Corporate Officer |
Feb 1, 2024 | 100% |
| W-2 Managing Employee |
Feb 1, 2024 | 100% | |
| Sarah a Thompson |
Corporate Director | Mar 1, 2012 | |
| W-2 Managing Employee | Mar 1, 2012 | ||
| Operational/Managerial Control | Mar 1, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120521000308 | GA | Part a Provider - Hospice | 1759579253 | Practice locations: Albany, GA |
National Provider Directory
- Tax ID family
- Affinis Hospice
Locations
223 W 3rd Ave
Albany, GA 31701
Phone (229) 435-0741
507 N Jefferson St
Albany, GA 31701
Phone (229) 435-2109
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 047-0327-H | GA | Yes |
Addresses
Primary practice location
507 N Jefferson St
Albany, GA 31701-2354
Mailing address
507 N Jefferson St
Albany, GA 31701-2354
Phone (229) 435-2109
Other names
- Affinis Hospice
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2023. 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.