Heritage Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HERITAGE HOSPICE INC

Practice address

1290 Kennestone Circle
Suite a-213
Marietta, GA 30066-6009

Phone

(770) 423-5959

Fax

(770) 423-5944

NPI assigned

Apr 4, 2006

Last updated

Oct 4, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shannon R Collins

Title

Administrator

Phone

(770) 423-5959

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275595415. Details of each certification follow.

• CCN 111614 Hospice · Active · Details

Hospice certification: CCN 111614

Legal name

HERITAGE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 5, 2004

Last certification

Aug 29, 2019

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jan 30, 2003 in GA

Enrollment address

3315 Hilltop Dr
Marietta, GA 30066-3787

Listed as

Heritage Hospice, IncCCN 111614 · All quality measures

Ownership

For-Profit

Certified

Aug 5, 2004

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

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.

• Milicent Eva Young, M.D.

  • Internal Medicine Physician
  • Acworth, GA
  • NPI 1265415269
  Medicare reassignment NPD

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1275595415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 KENNESTONE CIRCLE",
            "address_2": "SUITE A-213",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666009",
            "telephone_number": "770-423-5959",
            "fax_number": "770-423-5944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 KENNESTONE CIRCLE",
            "address_2": "SUITE A-213",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666009",
            "telephone_number": "770-423-5959",
            "fax_number": "770-423-5944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-423-5959",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Mosgovoy Henson
• James Allen Henson Jr., D.D.S.
• Kristian Hope Henson, RPSGT
• Morgan Elizabeth Hepler
• Her Wellness Circle, LLC
• Alan Herline, MD
• Robert C Hermann, MD
• Christina Hernandez
• Rachel Snider Hernandez, NP-C
• Herrin Pediatric Dentistry

• Community Based Hospice Care Agency in Marietta, GA
• Providers in Marietta, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.