NPIMap

Organization Active NPI

Integracare of Athens - Hospice, LLC

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Texarkana, TX
National Provider Identifier
1275858631
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
PENDING Issued in TX
Legal business name
INTEGRACARE OF ATHENS - HOSPICE, LLC
Doing business as
Gentiva
Practice address
5409 Plaza Dr
Texarkana, TX 75503-1662
Phone
(903) 675-8941
Fax
(903) 675-2289
NPI assigned
Mar 29, 2010
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Janet Combs
Title
SVP of Legal and Compliance
Phone
(704) 664-2876

Specialties & licenses 1

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

Addresses

Primary practice location

5409 Plaza Dr
Texarkana, TX 75503-1662

Mailing address

655 Brawley School Rd Ste 200
Mooresville, NC 28117-9601
Phone (704) 664-2876

Other names 1

  • Gentiva Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100730000938 TX Part A Provider - Hospice 5698808442 Practice locations: Texarkana, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275858631. Details of each certification follow.

Hospice certification: CCN 451583

Legal name
INTEGRACARE OF ATHENS - HOSPICE, LLC
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 7, 1993
Last certification
Jan 29, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
5409 Plaza Dr
Texarkana, TX 75503-1662

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 451583 · All quality measures
Ownership
For-Profit
Certified
Jul 7, 1993
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2049833Integracare of Athens-Hospice, LLC5409 Plaza Drive, Texarkana, TX 75503Certificate of waiverNov 14, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1315 S Palestine St
Athens, TX 75751
Phone (903) 675-5184

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Kentucky Homecare Parent Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Ronald C Lazas Individual Corporate OfficerCorp. Secretary & General Counsel Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
David Robinson Arnold Individual Corporate OfficerVP, Treasurer and Controller Dec 31, 2021
OtherVP, Treasurer, Controller Dec 31, 2021
Thomas Joseph Dolan Individual Corporate OfficerChief Financial Officer Nov 30, 2021
Charlotte Midco, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Falcon Hospice, LP Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerCeo and President Apr 27, 2021
Charlotte Buyer, Inc. Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Curo Health Services LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Direct Ownership Interest Mar 1, 2022 100%
Janet L Combs Individual Corporate OfficerVP of Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Centerwell Health Services Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2016 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Hollyn Fowler Individual W-2 Managing EmployeeAd; Aug 29, 2024
Russell E Mayo Individual Contracted Managing EmployeeMD; Apr 19, 2019
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%

Owners & managing parties with NPI records 19

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

View all 19

Facilities with the same owner 195

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

View all 195

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1269820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1275858631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BRAWLEY SCHOOL RD STE 200",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179601",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 PLAZA DR",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031662",
            "telephone_number": "903-675-8941",
            "fax_number": "903-675-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRACARE OF ATHENS - HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "SVP OF LEGAL AND COMPLIANCE",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Texarkana, TX

Sources for this page

Verify at the official NPI Registry.