New Beacon Healthcare Group, LLC
Organization Active NPI Community Based Hospice Care Agency · Northport, AL
NPI 1376572255 · NPPES record last updated Aug 27, 2026
Key facts
- NPI
- 1376572255
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- NEW BEACON HEALTHCARE GROUP, LLC
- Practice address
- 3835 Watermelon Rd Ste B&C
Northport, AL 35473-5001 - Phone
- (205) 469-0273
- Fax
- (205) 469-0276
- NPI assigned
- Jul 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Jennifer Tyler
- Title
- VP of Regulatory Counsel
- Phone
- (704) 664-2876
Owners & managing parties with NPI records 18
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 14
Member of 1
Facilities with the same owner 195
Affiliated clinicians 25
-
William Eugene Alldredge, M.D.
-
Sadri M Avsar, MD
-
Gregory Wayne Ayers, M.D.
-
Mohannad Fadl Azzam, M.D.
-
Meghan Bonds, MD
-
Julia Lett Boothe, M.D.
-
Jack Newton Burns, D.O.
-
Park Thetford Chittom II, M.D.
-
Park Thetford Chittom, M.D.
-
Glenton W Davis, M.D.
-
Scott R Fulgham, M.D.
-
Tyler Dean Goins, M.D.
-
Erik Paul Lessmann, M.D.
-
Remona Peterson, MD
-
Michael A Rosemore, D.O.
-
John C Simmons, MD
-
Joseph Grier Stewart Jr., M.D.
-
David Ibrahim, M.D.
Medicare Care Compare: Hospice
- Listed as
- Southerncare New Beacon - Jasper
- Ownership
- For-Profit
- Certified
- Nov 19, 1986
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 01D2055912 | New Beacon Healthcare Group LLC | Certificate of waiver | Mar 18, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Hospice certification: CCN 011506
- Legal name
- NEW BEACON HEALTHCARE GROUP, LLC
- Doing business as
- SOUTHERNCARE NEW BEACON OF JASPER
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 19, 1986
- Last certification
- Jun 17, 2016
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- May 30, 2006 in DE
- Enrollment address
- 300 North Airport Road
Units 3 and 4
Jasper, AL 35504-2517
All disclosed owners & managing parties 22
| Name | Role | Since | Share |
|---|---|---|---|
| Jordan Marie Fanelli |
W-2 Managing Employee |
Feb 23, 2023 | |
| CH Services Midco Holdings Inc |
5% Or Greater Indirect Ownership Interest | Feb 5, 2015 | 100% |
| Kentucky Homecare Parent Inc. |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 40% |
| Ronald C Lazas |
Corporate Officer |
Apr 27, 2021 | |
| Curo Health Services Holdings, Inc |
5% Or Greater Indirect Ownership Interest | Nov 9, 2011 | 100% |
| David Robinson Arnold |
Corporate Officer |
Dec 31, 2021 | |
| W-2 Managing Employee |
Dec 31, 2021 | ||
| Thomas Joseph Dolan |
Corporate Officer |
Nov 30, 2021 | |
| Charlotte Midco, LLC |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 100% |
| Kentucky Homecare Holdings, Inc. |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 40% |
| Humana Inc |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 40% |
| Falcon Hospice, LP |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 100% |
| David Allen Causby |
Corporate Officer |
Apr 27, 2021 | |
| Regency Healthcare Holdings LLC |
5% Or Greater Indirect Ownership Interest | Jun 6, 2014 | 100% |
| Charlotte Buyer, Inc. |
5% Or Greater Indirect Ownership Interest | Jul 11, 2018 | 100% |
| Curo Health Services LLC |
5% Or Greater Indirect Ownership Interest | Jun 1, 2012 | 100% |
| Janet L Combs |
Corporate Officer |
Nov 1, 2021 | |
| CD&R Falcon Holdings, LP |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 60% |
| Centerwell Health Services Inc |
5% Or Greater Indirect Ownership Interest | Aug 11, 2022 | 40% |
| Kah Hospice Company, Inc |
5% Or Greater Indirect Ownership Interest | Mar 1, 2022 | 100% |
| Regency Healthcare Group LLC |
5% Or Greater Direct Ownership Interest | Jul 1, 2006 | 100% |
| Operational/Managerial Control | Jul 1, 2006 | 100% | |
| CH Services Group Holdings Inc |
5% Or Greater Indirect Ownership Interest | Feb 5, 2015 | 100% |
| CH Services Holdings Inc |
5% Or Greater Indirect Ownership Interest | Feb 5, 2015 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060907000536 | AL | Part a Provider - Hospice | 5092719955 | Practice locations: Demopolis, AL; Selma, AL; Jasper, AL; Birmingham, AL |
National Provider Directory
- Tax ID family
- New Beacon Healthcare Group LLC
Locations
300 N Airport Rd
Ste 3
Jasper, AL 35504
Phone (205) 287-9339
3835 Watermelon Rd
Ste 34
Northport, AL 35473
Phone (205) 469-0273
3835 Watermelon Rd
Ste Bc
Northport, AL 35473
Phone (205) 469-0273
900 Church St
Ste 123
Selma, AL 36701
Phone (334) 526-4414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
3835 Watermelon Rd Ste B&C
Northport, AL 35473-5001
Mailing address
PO Box 4060
Attn: Regulatory
Mooresville, NC 28117-4060
Phone (704) 664-2876
Other practice location 1
900 Church St Ste 123
Selma, AL 36701-4550
Phone (334) 526-4414
Other practice location 2
1280 Columbiana Rd Ste 110
Vestavia Hills, AL 35216-1605
Phone (205) 868-1100
Other practice location 3
927 US Highway 80 W
Demopolis, AL 36732-4102
Phone (334) 289-9522
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 188760 | Medicaid | AL | |
| 188811 | Medicaid | AL | |
| 187197 | Medicaid | AL | |
| PIC1506E | Medicaid | AL |
Other names
- New Beacon of Jasper
- SouthernCare New Beacon - Jasper
Other providers in Northport, AL
- Olivia P Nagus
- Richard Navickas II
- Ashley Marie Neuhauser
- Neurology Clinic, P.C.
- Neuropsychology Clinic
- Seth Peyton Nicholas
- Alicia O Nichols
- Julie Beth Nicholson
- Tameka Chardell Noland
- Northport - Crna
All providers in Northport, AL · Community Based Hospice Care Agency in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2026. 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.