In Home Health, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

IN HOME HEALTH, LLC

Doing business as

ProMedica Hospice (Augusta)

Practice address

4487 Columbia Rd Ste 103
Martinez, GA 30907-4255

Phone

(706) 860-7374

Fax

(706) 860-9410

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ProMedica Hospice (Augusta) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

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

• Southerncare, Inc.

  • Community Based Hospice Care Agency
  • Martinez, GA
  • NPI 1720787211

  Sold to, 2023-11-01

  CMS change of ownership

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1336194356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N. SUMMIT ST.",
            "address_2": "ATTN: LEGAL DEPARTMENT",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4487 COLUMBIA RD STE 103",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309074255",
            "telephone_number": "706-860-7374",
            "fax_number": "706-860-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000848317F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP080",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Augusta)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Augusta)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sue Howell-Fafchamps, LCSW, LMSW,LISW-CP
• Reagan Huber
• Cassandre Elena Dujour Hudson, LCSW
• Mark Leslie Huntsman, D.C.
• Jamie S Hurst-Larson, SLP-CCC
• Independent Physical Therapy of Ga, LLC
• Savannah Insalaco
• Integrity Health
• Interpoint Primary Care, LLC
• Anthony Benavente Ishmael Jr.

• Community Based Hospice Care Agency in Martinez, GA
• Providers in Martinez, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.