Lighthouse Hospice Group, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LIGHTHOUSE HOSPICE GROUP, LLC

Practice address

110 Oak Park Dr
Unit C
Irmo, SC 29063-6110

Phone

(803) 781-1935

Fax

(803) 781-1936

NPI assigned

May 11, 2011

Organization subpart

No

Name

Jennifer Gabriel, DPT

Title

President/Co-Owner

Phone

(803) 351-1607

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

• Benjamin J Levinson, MD

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1346208865
  CMS ownership CONTRACTED MANAGING EMPLOYEE

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Benjamin J Levinson, MD

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1346208865
  NPD (past)

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

• Lori L Cook, M.D.

  • Internal Medicine Physician
  • Columbia, SC
  • NPI 1255317723
  Care Compare affiliation Hospice
• Joseph N Gabriel, MD

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1093773590
  Care Compare affiliation Hospice
• Benjamin J Levinson, MD

  • Internal Medicine Physician
  • Irmo, SC
  • NPI 1346208865
  Care Compare affiliation Hospice

Listed as

Lighthouse Hospice Group, LLCCCN 421608

Ownership

For-Profit

Certified

Oct 12, 2011

Medicare certification status

Active (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

Medicare fee-for-service enrollment

Enrolled in SC

Legal name

LIGHTHOUSE HOSPICE GROUP, LLC

Doing business as

LIGHTHOUSE HOSPICE GROUP

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 12, 2011

Last certification

Feb 18, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Mar 23, 2011 in SC

Enrollment address

110 Oak Park Dr
Ste C
Irmo, SC 29063-6110

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

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 11, 2011.

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1295027159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 OAK PARK DR",
            "address_2": "UNIT C",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290636110",
            "telephone_number": "803-781-1935",
            "fax_number": "803-781-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 OAK PARK DR",
            "address_2": "UNIT C",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290636110",
            "telephone_number": "803-781-1935",
            "fax_number": "803-781-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE HOSPICE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT/CO-OWNER",
        "authorized_official_telephone_number": "803-351-1607",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.