Ihc Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0250279H Issued in GA

Legal business name

IHC HOSPICE, INC.

Doing business as

Island Hospice

Practice address

3 W Perry St
Savannah, GA 31401-3951

Phone

(912) 629-2727

Fax

(912) 234-1718

NPI assigned

Mar 12, 2007

Last updated

Oct 19, 2021By 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

Ellen B Bolch

Title

President-Ceo

Phone

(912) 629-2727

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Island Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285766485. Details of each certification follow.

• CCN 111663 Hospice · Active · Details

Hospice certification: CCN 111663

Legal name

IHC HOSPICE INC

Doing business as

ISLAND HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 24, 2007

Last certification

Mar 3, 2021

Ownership / control type

Other

Organization structure

CorporationNon-profit

Incorporated

Jun 26, 2003 in SC

Enrollment address

4 Skidaway Village Walk
Ste E
Savannah, GA 31411-2962

Other NPIs with the same Medicare PAC ID 1

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

• Ihc Hospice Inc

  dba Island Hospice

  • Community Based Hospice Care Agency
  • Hardeeville, SC
  • NPI 1134125669

  0042310021

  Same PAC ID

Listed as

Island Hospice, IncCCN 111663 · All quality measures

Ownership

Non-Profit

Certified

Oct 24, 2007

Medicare certification status

ActiveFrom the Provider of Services file

All disclosed owners & managing parties 1

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

Affiliated clinicians 1

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

• Jules Victor III, M.D.

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1306845029

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1285766485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 W PERRY ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013951",
            "telephone_number": "912-629-2727",
            "fax_number": "912-234-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 W PERRY ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314013951",
            "telephone_number": "912-629-2727",
            "fax_number": "912-234-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "BOLCH",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT-CEO",
        "authorized_official_telephone_number": "912-629-2727"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "0250279H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "0250279H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Island Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shy'Nya Hymon
• John F Iaderosa, PA
• Gordon G Ifill, M.D.
• Ana Ifti, MD
• Ornela Ifti, MD
• Ihc III (Independent Life at Home)
• Shari Ikenberg
• Ilan D Bornstein, M.D., L L C
• Olayinka T Ilesanmi
• William Amos Immel, L.P.C.

• Community Based Hospice Care Agency in Savannah, GA
• Providers in Savannah, 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 19, 2021; 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.