NPIMap

Organization Active NPI

Southerncare, Inc.

Doing business as Heartland

  • Community Based Hospice Care Agency
  • Macon, GA
National Provider Identifier
1316646508
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SOUTHERNCARE, INC.
Doing business as
Heartland
Practice address
5400 Riverside Dr Ste 200
Macon, GA 31210-0816
Phone
(478) 477-0101
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Authorized official

Name
Janet L. Combs
Title
VP of Licensure
Phone
(704) 664-2876

Specialties & licenses 1

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

Addresses

Primary practice location

5400 Riverside Dr Ste 200
Macon, GA 31210-0816

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 664-2876

Other names 1

  • Heartland Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231113000139 GA Part A Provider - Hospice 8527977735 Practice locations: Macon, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316646508. Details of each certification follow.

Hospice certification: CCN 111603

Legal name
SOUTHERNCARE, INC.
Doing business as
HEARTLAND HOSPICE (MACON)
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 27, 2003
Last certification
Mar 2, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 30, 2002 in DE
Enrollment address
5400 Riverside Dr
Ste 200
Macon, GA 31210-0816

Care Compare: Hospice

Medicare Care Compare
Listed as
Heartland Hospice- MaconCCN 111603 · All quality measures
Ownership
For-Profit
Certified
Feb 27, 2003
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
11D1014928Southerncare, Inc5400 Riverside Drive Suite 200, Macon, GA 31210Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Southerncare Inc43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 23

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, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
Kentucky Homecare Parent Inc. Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerEvp, Secretary & General Counsel Apr 27, 2021
Corporate DirectorBoard Member Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
David Robinson Arnold Individual Corporate OfficerVP, Treasurer & Controller Dec 31, 2021
Operational/Managerial ControlChain Home Office Administrator Dec 31, 2021
Curo Hospice SC LLC Organization, Mooresville, NC LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Thomas Joseph Dolan Individual Corporate OfficerChief Financial Officer Nov 30, 2021
Ksoc Holdings, Inc Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 1, 2011 100%
Southerncare Holdings, Inc. Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Dec 30, 2002 100%
Charlotte Midco, LLC Organization, Atlanta, GA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 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 Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerPresident & Ceo Apr 27, 2021
Corporate DirectorBoard Member Apr 27, 2021
Christine Manning Raper Individual W-2 Managing EmployeeAdministrator Sep 21, 2017
Charlotte Buyer, Inc. Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 11, 2008 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Janet L Combs Individual Corporate OfficerVP of Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Centerwell Health Services Inc Organization, Louisville, KY Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 22, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%

Owners & managing parties with NPI records 18

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

View all 18

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Gentiva IICincinnati, OH, CCN 361704 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017

Facilities with the same owner 195

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

View all 195

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the buyer Promedica Hospice (Macon)CCN 111603, GA, NPI 1184670648

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Affiliated clinicians 5

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": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1316646508",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 RIVERSIDE DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100816",
            "telephone_number": "478-477-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERNCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "L.",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.