NPIMap

Organization Active NPI

Pinnacle Care Holdings LLC

  • Community Based Hospice Care Agency
  • Baton Rouge, LA
National Provider Identifier
1245760164
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PINNACLE CARE HOLDINGS LLC
Practice address
5627 S Sherwood Forest Blvd Ste C
Baton Rouge, LA 70816-6032
Phone
(225) 248-8600
NPI assigned
Jun 13, 2017
Last updated
Jun 13, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
PINNACLE CARE HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Authorized official

Name
Kelly Tullier
Title
Cfo
Phone
(225) 248-8600

Specialties & licenses 1

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

Addresses

Primary practice location

5627 S Sherwood Forest Blvd Ste C
Baton Rouge, LA 70816-6032

Mailing address

5627 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6032
Phone (225) 248-8600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170825001469 LA Part A Provider - Hospice 7315219383 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245760164. Details of each certification follow.

Hospice certification: CCN 191662

Legal name
PINNACLE CARE HOLDINGS LLC
Doing business as
PINNACLE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 8, 2008
Last certification
Nov 10, 2021
Ownership / control type
Other
Organization structure
LLCProprietary
Enrollment address
5627 S. Sherwood Forest Blvd
Baton Rouge, LA 70816-6032

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Pinnacle HospiceCCN 191662 · All quality measures
Ownership
For-Profit
Certified
Apr 8, 2008
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Pinnacle Care Holdings LLC5 organizations share this tax ID, including this one
Part of
Pinnacle Care Holdings LLC

Other organizations with this tax ID 4

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

5627 S Sherwood Forest Blvd
Ste C
Baton Rouge, LA 70816
Phone (225) 214-0043

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Our Lady of the Lake Hospital Inc Organization, Baton Rouge, LA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 18, 2017 80%
5% Or Greater Indirect Ownership Interest Jun 18, 2017 100%
Franciscan Missionaries of Our Lady Health System Inc Organization, Baton Rouge, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 18, 2017 80%
Jonathan P Lyons Individual 5% Or Greater Direct Ownership Interest Jun 18, 2017 10%
Andre a Bonnecaze Individual Contracted Managing EmployeeMD; Jun 18, 2017
Kelly T Tullier Individual 5% Or Greater Direct Ownership Interest Jun 18, 2017 10%
W-2 Managing EmployeeAd;Cfo Jun 18, 2017
Fmol-North American Providence Inc Organization, Baton Rouge, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jun 18, 2017 80%

Owners & managing parties with NPI records 7

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 19

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

View all 19

Change-of-ownership history 1

DateEventCounterparty
Jun 18, 2017 Change of OwnershipThis provider was the buyer Pinnacle HospiceCCN 191662, LA, NPI 1285830711

Change of ownership 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1245760164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166032",
            "telephone_number": "225-248-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5627 S SHERWOOD FOREST BLVD STE C",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166032",
            "telephone_number": "225-248-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINNACLE CARE HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PINNACLE CARE HOLDINGS LLC",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "TULLIER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-248-8600"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.