NPIMap

Organization Active NPI

Kindred Hospice Missouri, LLC

Doing business as Gentiva

  • Community Based Hospice Care Agency
  • Jefferson City, MO
National Provider Identifier
1346719473
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
KINDRED HOSPICE MISSOURI, LLC
Doing business as
Gentiva
Kindred Hospice
Practice address
1616 Southridge Dr Ste 201
Jefferson City, MO 65109-5677
Phone
(573) 469-4895
Fax
(573) 469-4896
NPI assigned
Nov 19, 2018
Last updated
Jan 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 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) 662-1761

Specialties & licenses 1

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

Addresses

Primary practice location

1616 Southridge Dr Ste 201
Jefferson City, MO 65109-5677

Mailing address

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

Other names 2

  • Gentiva Doing business as
  • Kindred Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191101001623 MO Part A Provider - Hospice 5193057651 Practice locations: Jefferson City, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346719473. Details of each certification follow.

Hospice certification: CCN 261684

Legal name
KINDRED HOSPICE MISSOURI LLC
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 6, 2020
Last certification
Oct 6, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Nov 12, 2015 in DE
Enrollment address
1616 Southridge Dr
Ste 201
Jefferson City, MO 65109-5677

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 261684 · All quality measures
Ownership
For-Profit
Certified
Oct 6, 2020
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
26D2174037Kindred Hospice Missouri, LLC1616 Southridge Drive, Ste 201, Jefferson City, MO 65109Certificate of waiverOct 22, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1616 Southridge Dr
Ste 201
Jefferson Cty, MO 65109
Phone (573) 469-4895

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
Michael T Rothermich Individual Contracted Managing EmployeeMD; May 1, 2016
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2019 100%
Kentucky Homecare Parent Inc. Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 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 Nov 1, 2019 100%
Mary Rose Gonzalez Individual W-2 Managing EmployeeAd; Jul 7, 2025
David Robinson Arnold Individual Corporate OfficerVP, Treasurer & 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 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 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 Nov 1, 2019 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit, Chain home office 5% Or Greater Direct Ownership Interest Nov 1, 2019 100%
Operational/Managerial Control Nov 1, 2019 100%
Janet L Combs Individual Corporate OfficerVP of Licensure 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%
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2019 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Nov 1, 2019 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

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": "1542585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1346719473",
    "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": "1616 SOUTHRIDGE DR STE 201",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095677",
            "telephone_number": "573-469-4895",
            "fax_number": "573-469-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINDRED HOSPICE MISSOURI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-19",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-662-1761"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindred Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.