Marmalade Healthcare LLC

Primary specialty

Inpatient HospiceTaxonomy code 315D00000X

License

107151H Issued in GA

Legal business name

MARMALADE HEALTHCARE LLC

Practice address

215 Azalea CT
Social Circle, GA 30025-5037

Phone

(770) 464-5858

Fax

(770) 464-5870

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Ellen T Petry, RN

Title

Executive Administrator

Phone

(770) 464-5858

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Abbey Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 111530

Legal name

MARMALADE HEALTHCARE LLC

Doing business as

ABBEY HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 1, 1994

Last certification

Sep 30, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Feb 1, 2000 in GA

Enrollment address

215 Azalea Court
Social Circle, GA 30025-5037

Listed as

Abbey HospiceCCN 111530

Ownership

For-Profit

Certified

Feb 1, 1994

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua A King, MD

  • Internal Medicine Physician
  • Stockbridge, GA
  • NPI 1003814591
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Nataliya Kubasova, MD

  • Family Medicine Physician
  • Monticello, GA
  • NPI 1942563770

  Hospice

  Care Compare affiliation
• Derrick F Lane, M.D.

  • Family Medicine Physician
  • Macon, GA
  • NPI 1124079447

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356498737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 AZALEA CT",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300255037",
            "telephone_number": "770-464-5858",
            "fax_number": "770-464-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 AZALEA CT",
            "city": "SOCIAL CIRCLE",
            "state": "GA",
            "postal_code": "300255037",
            "telephone_number": "770-464-5858",
            "fax_number": "770-464-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARMALADE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PETRY",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "770-464-5858",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "107151H",
            "primary": false
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "GA",
            "license": "107151H",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00598925",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abbey Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donovan D. Jones Jr., DMD
• Just for Kids Therapy Services, Inc.
• Kevin D Lanclos, MD
• Kimberly Gibson Lane, RDN
• Denny Lee Malcom, DDS
• Marmalade Pallative Health LLC
• Marmalade Palliative Care LLC
• Christopher Mattocks
• Alicia McGee, PTA
• Misericordia Home Care Services Inc

• Inpatient Hospice in Social Circle, GA
• Providers in Social Circle, GA by specialty
• Inpatient Hospice in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.