Affinis Hospice, LLC
Organization Active NPI Community Based Hospice Care Agency · Gray, GA
NPI 1326515719 · NPPES record last updated Nov 3, 2023
Key facts
- NPI
- 1326515719
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- AFFINIS HOSPICE, LLC
- Practice address
- 300 W Clinton St Ste I
Gray, GA 31032-5329 - Phone
- (478) 936-8959
- Fax
- (478) 986-5771
- NPI assigned
- Oct 24, 2018
- Organization subpart
- No
Authorized official
- Name
- Sarah Absher Thompson
- Title
- Vice President of Operations
- Phone
- (912) 538-0465
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 10
Member of 1
Facilities with the same owner 11
Practitioners 4
-
Trista Jacinta Marshall, M.D.
-
Terry Newton, MD
Affiliated clinicians 4
-
Ajay Kumar, M.D.
-
Dave A Ringer, MD
Medicare Care Compare: Hospice
- Listed as
- Affinis Hospice, LLC
- Ownership
- For-Profit
- Certified
- Sep 4, 2019
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Hospice certification: CCN 851514
- Legal name
- AFFINIS HOSPICE, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 4, 2019
- Last certification
- Sep 4, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Non-profit
- Incorporated
- Dec 9, 2009
- Enrollment address
- 300 W Clinton St
Ste I
Gray, GA 31032-5329
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Home and Community Services Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2021 | 100% |
| Leslie Nelson |
Operational/Managerial Control |
Jan 4, 2026 | 100% |
| Maulikkumar a Patel |
Operational/Managerial Control |
Jul 1, 2025 | 100% |
| Sarah a Thompson |
Corporate Officer |
Nov 1, 2018 | 100% |
| W-2 Managing Employee |
Nov 1, 2018 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190205003343 | GA | Part a Provider - Hospice | 1759579253 | Practice locations: Gray, GA |
National Provider Directory
- Tax ID family
- Affinis Hospice
Locations
15 Bowen Ct
#B
Cartersville, GA 30120
Phone (678) 689-2343
2565 Thompson Bridge Rd
Ste 110
Gainesville, GA 30501
Phone (678) 989-0981
300 W Clinton St
Ste I
Gray, GA 31032
Phone (478) 936-8959
2402 Tift Ave N
Tifton, GA 31794
Phone (229) 382-7898
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
300 W Clinton St Ste I
Gray, GA 31032-5329
Mailing address
806 Maple Dr
Vidalia, GA 30474-7208
Phone (912) 538-0465
Other providers in Gray, GA
- Eleanya Agwu
- Alexis Private Home Care, Inc.
- Jennie Carlene Allen
- Amedisys Georgia, L.L.C.
- Aml Medical LLC
All providers in Gray, GA · Community Based Hospice Care Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.