Organization Active NPI

Georgia Mountains Hospice, Inc

  • Community Based Hospice Care Agency
  • Jasper, GA
National Provider Identifier
1295767291
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
251G00000X Issued in GA
Legal business name
GEORGIA MOUNTAINS HOSPICE, INC
Practice address
70 Caring Way
Jasper, GA 30143-1960
Phone
(706) 253-4100
NPI assigned
Jul 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Ms. Marie Lindsey
Title
Administrator
Phone
(706) 253-4100

Specialties & licenses 1

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

Addresses

Primary practice location

70 Caring Way
Jasper, GA 30143-1960

Mailing address

70 Caring Way
Jasper, GA 30143-1960

Other identifiers 1

IdentifierTypeStateIssuer
00575693AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090604000147 GA Part A Provider - Hospice 4981754413 Practice locations: Jasper, GA
O20201207001483 GA Part B Supplier - Clinic/Group Practice 4981754413 Receives reassigned benefits from 1 practitioner
Practice locations: Jasper, GA

Hospice certification: CCN 111532

Legal name
GEORGIA MOUNTAINS HOSPICE, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 17, 1993
Last certification
Jan 27, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Jun 16, 1993 in GA
Enrollment address
70 Caring Way
Jasper, GA 30143-1960

Care Compare: Hospice

Medicare Care Compare
Listed as
Georgia Mountain Hospice, Inc.CCN 111532
Ownership
Non-Profit
Certified
Sep 17, 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
11D0877538Georgia Mountains Hospice Inc70 Caring Way, Jasper, GA 30143Certificate of waiverOct 4, 2027

National Provider Directory

National Provider Directory

Locations

70 Caring Way
Jasper, GA 30143
Phone (706) 253-4100

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Mary a Bramlett Individual Corporate OfficerCfo, HR Dir Jun 4, 2010
W-2 Managing EmployeeCfo, HR Dir Jun 4, 2010
Gina Pendley Individual Corporate OfficerExe Dir Jul 30, 2012
Corporate DirectorExe Dir Jul 30, 2012
W-2 Managing EmployeeExe Dir Jul 30, 2012

Practitioners & affiliated clinicians

Practitioners 1

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

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": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1295767291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 CARING WAY",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CARING WAY",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "301431960",
            "telephone_number": "706-253-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS HOSPICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "LINDSEY",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-253-4100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "251G00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00575693A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, GA

Sources for this page

Verify at the official NPI Registry.