NPIMap

Organization Active NPI

Southerncare, Inc.

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Oxford, MS
National Provider Identifier
1326088154
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
203 Issued in MS
Legal business name
SOUTHERNCARE, INC.
Doing business as
Gentiva
Practice address
512 Azalea Dr
Oxford, MS 38655-8100
Phone
(662) 578-4072
Fax
(662) 578-7956
NPI assigned
Jun 8, 2006
Last updated
Apr 21, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X MS
Community Based Hospice Care Agency 251G00000X 203 MS Primary

Addresses

Primary practice location

512 Azalea Dr
Oxford, MS 38655-8100

Mailing address

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

Other practice location 1

6858 Swinnea Rd Bldg 6A
Southaven, MS 38671-9493
Phone (662) 349-3430

Other practice location 2

218 Oxford Rd Ste A
New Albany, MS 38652-3115
Phone (662) 841-0085

Other identifiers 2

IdentifierTypeStateIssuer
01263801MedicaidMS
09874721MedicaidMS

Other names 1

  • Gentiva Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081120000510 MS Part A Provider - Hospice 8527977735 Practice locations: Oxford, MS; Southaven, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326088154. Details of each certification follow.

Hospice certification: CCN 251671

Legal name
SOUTHERNCARE, INC.
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 28, 2011
Last certification
Mar 29, 2018
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 30, 2002 in DE
Enrollment address
512 Azalea Dr
Oxford, MS 38655-8100

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 251671 · All quality measures
Ownership
For-Profit
Certified
Sep 28, 2011
Medicare certification status
ActiveFrom the Provider of Services file

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 For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
Kentucky Homecare Parent Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerExecutive Vice President and Genera Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
David Robinson Arnold Individual Corporate OfficerVP and Controller Dec 31, 2021
W-2 Managing EmployeeHome Office Administrator Dec 31, 2021
Curo Hospice SC LLC Organization, Mooresville, NC Created for acquisition, Corporation 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 5% Or Greater Indirect Ownership Interest Dec 1, 2011
Southerncare Holdings, Inc. Organization, Mooresville, NC Corporation 5% Or Greater Direct Ownership Interest Aug 11, 2008
Charlotte Midco, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Penny Deeann Conlee Individual W-2 Managing EmployeeAdministrator Dec 6, 2021
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 and Preside Apr 27, 2021
Charlotte Buyer, Inc. Organization, Fort Worth, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jul 11, 2018 100%
Curo Health Services LLC Organization, Mooresville, NC Non-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Janet L Combs Individual Corporate OfficerVP Licensure, Authorized Official 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, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
CH Services Group Holdings Inc Organization, Mooresville, NC For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
CH Services Holdings Inc Organization, Mooresville, NC 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

Practitioners & affiliated clinicians

Affiliated clinicians 9

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": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1326088154",
    "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": "704-662-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 AZALEA DR",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386558100",
            "telephone_number": "662-578-4072",
            "fax_number": "662-578-7956"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6858 Swinnea Rd Bldg 6A",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386719493",
            "country_code": "US",
            "telephone_number": "662-349-3430",
            "fax_number": "844-778-4380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "218 Oxford Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "MS",
            "postal_code": "386523115",
            "country_code": "US",
            "telephone_number": "662-841-0085",
            "fax_number": "662-841-0721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHERNCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01263801",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09874721",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.