NPIMap

Organization Active NPI

Community Hospices of America LLC

Doing business as Hospice Compassus - Southern West Virginia

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Princeton, WV
National Provider Identifier
1215487640
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
COMMUNITY HOSPICES OF AMERICA LLC
Doing business as
Hospice Compassus - Southern West Virginia
Practice address
1330 Mercer St
Princeton, WV 24740
Phone
(304) 431-2000
Fax
(304) 431-2002
NPI assigned
Oct 10, 2016
Last updated
May 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X Primary

Addresses

Primary practice location

1330 Mercer St
Princeton, WV 24740

Mailing address

10 Cadillac Dr
Suite 400
Brentwood, TN 37027-5078
Phone (417) 841-4834

Other names 1

  • Hospice Compassus - Southern West Virginia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150617001297 WV Part B Supplier - Clinic/Group Practice 4385552660 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Princeton, WV

Other NPIs with the same Medicare PAC ID 10

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Community Hospices LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hospice Compassus JoplinJoplin, MO, CCN 261593 Hospice 5% Or Greater Indirect Ownership Interest (100%) Jan 6, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1215487640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR",
            "address_2": "SUITE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275078",
            "telephone_number": "417-841-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 MERCER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "24740",
            "telephone_number": "304-431-2000",
            "fax_number": "304-431-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPICES OF AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice Compassus - Southern West Virginia",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice Compassus - Southern West Virginia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, WV

Sources for this page

Verify at the official NPI Registry.