NPIMap

Organization Active NPI

Addison County Home Health & Hospice Inc

  • Community Based Hospice Care Agency
  • New Haven, VT
National Provider Identifier
1255452728
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ADDISON COUNTY HOME HEALTH & HOSPICE INC
Practice address
254 Ethan Allen Highway
New Haven, VT 05472
Phone
(802) 388-7259
Fax
(802) 388-6126
NPI assigned
Apr 3, 2007
Last updated
Jul 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Authorized official

Name
Mr. Tim Brownell
Title
Executive Director
Phone
(802) 388-7259

Specialties & licenses 1

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

Addresses

Primary practice location

254 Ethan Allen Highway
New Haven, VT 05472

Mailing address

PO Box 754
Middlebury, VT 05753-0754
Phone (802) 388-7259

Other identifiers 1

IdentifierTypeStateIssuer
471508MedicaidVT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411002522 VT Part A Provider - Hospice 4587983374 Practice locations: New Haven, VT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255452728. Details of each certification follow.

Hospice certification: CCN 471508

Legal name
ADDISON COUNTY HOME HEALTH& HOSPICE, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 16, 1997
Last certification
Mar 30, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 23, 1969 in VT
Enrollment address
254 Ethan Allen Hwy
New Haven, VT 05472-1045

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Addison County HHA HospiceCCN 471508 · All quality measures
Ownership
For-Profit
Certified
Dec 16, 1997
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Addison County Home Health Hospice Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

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
Sarah B Taylor Individual Corporate DirectorTreasurer Jan 1, 2023
Marie Jewett Individual Corporate DirectorVice President Jan 1, 2023
William B Miller Individual Corporate DirectorPresident Jan 1, 2023
Deborah E Wesley Individual Corporate OfficerCeo Feb 17, 2019
Elizabeth Roberts Individual Corporate DirectorSecretary Jan 1, 2023
Janine Podraza Individual Corporate DirectorCfo Aug 19, 2019
W-2 Managing EmployeeCfo Aug 19, 2019

Practitioners & affiliated clinicians

Affiliated clinicians 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499299200000",
    "number": "1255452728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 754",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057530754",
            "telephone_number": "802-388-7259",
            "fax_number": "802-388-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 ETHAN ALLEN HIGHWAY",
            "city": "NEW HAVEN",
            "state": "VT",
            "postal_code": "05472",
            "telephone_number": "802-388-7259",
            "fax_number": "802-388-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADDISON COUNTY HOME HEALTH & HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2017-07-06",
        "status": "A",
        "authorized_official_last_name": "BROWNELL",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-388-7259",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "471508",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, VT

Sources for this page

Verify at the official NPI Registry.