NPIMap

Organization Active NPI

Bethany Hospice, LLC

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Georgetown, TX
National Provider Identifier
1295899284
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
009947 Issued in TX
Legal business name
BETHANY HOSPICE, LLC
Doing business as
Gentiva
Practice address
2913 Williams Dr.
Suite 320
Georgetown, TX 78628-2740
Phone
(512) 868-0505
NPI assigned
Dec 21, 2006
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
VP of Licensure
Phone
(704) 664-2876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 009947 TX Primary

Addresses

Primary practice location

2913 Williams Dr.
Suite 320
Georgetown, TX 78628-2740

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
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
O20050819000334 TX Part A Provider - Hospice 5991735821 Practice locations: Georgetown, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295899284. Details of each certification follow.

Hospice certification: CCN 671517

Legal name
BETHANY HOSPICE, LLC
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 19, 2005
Last certification
Feb 7, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
2913 Williams Dr
Ste 320
Georgetown, TX 78628-2740

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 671517 · All quality measures
Ownership
For-Profit
Certified
Dec 19, 2005
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
45D1049328Bethany Hospice LLC Dba Gentiva2913 Williams Drive, Suite 320, Georgetown, TX 78628Certificate of waiverDec 5, 2026

National Provider Directory

National Provider Directory

Member of 1

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

Locations

8701 N Mopac Expy
Ste 300
Austin, TX 78759
Phone (212) 634-4900

2913 Williams Dr
Ste 320
Georgetown, TX 78628
Phone (512) 868-0505

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, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 22, 2022 40%
Ronald C Lazas Individual Corporate OfficerExecutive VP and 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 and 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, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 22, 2022 40%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerChief Executive Officer & 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, Mooresville, NC LLC, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Mar 1, 2022 100%
Janet L Combs Individual Corporate OfficerAssistant Secretary 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, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 22, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Wendi Gann Individual W-2 Managing EmployeeAd; Oct 10, 2024
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Philip M Woodall Individual Contracted Managing EmployeeMD; Sep 1, 2012
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

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.

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": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1295899284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "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": "2913 WILLIAMS DR.",
            "address_2": "SUITE 320",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282740",
            "telephone_number": "512-868-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHANY HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "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": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "009947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

Verify at the official NPI Registry.