Passionate Care Hospice and Palliative Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PASSIONATE CARE HOSPICE AND PALLIATIVE CARE LLC

Practice address

2272 Azalea Dr Ste a
Lawrenceville, GA 30043-2653

Phone

(770) 680-4340

NPI assigned

Jan 4, 2022

Last updated

Nov 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Scholar IbezimNPI 1184257404

Title

Administrator

Phone

(770) 680-4340

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386305282. Details of each certification follow.

• CCN 851529 Hospice · Active · Details

Hospice certification: CCN 851529

Legal name

PASSIONATE CARE HOSPICE AND PALLIATIVE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 22, 2020

Last certification

Jun 22, 2020

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Enrollment address

2272 Azalea Dr
Ste a
Lawrenceville, GA 30043-2653

Listed as

Passionate Care Hospice and Palliative Care, LLCCCN 851529 · All quality measures

Ownership

For-Profit

Certified

Jun 22, 2020

Medicare certification status

ActiveFrom the Provider of Services file

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.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jean Joseph Philippe-Dambreville, MD

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1639177066

  Contracted Managing Employee, Corporate Officer

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scholar Ibezim

  • Hospice Registered Nurse
  • Lawrenceville, GA
  • NPI 1184257404
  Authorized official Same address or phone

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

{
    "created_epoch": "1641254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1386305282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2272 AZALEA DR STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432653",
            "telephone_number": "770-680-4340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2272 AZALEA DR STE A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300432653",
            "telephone_number": "770-680-4340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSIONATE CARE HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-04",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "IBEZIM",
        "authorized_official_first_name": "SCHOLAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-680-4340"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Paryo
• Sherlanda Pascal
• Jade Paschall
• Samantha Rae Pasko, MSW
• Passionate Care Givers Home Care Services LLC
• Passport Health Holdings LLC
• Mercy Paszkiewicz VI
• Robert Pate, RPH
• Vadia Pierre Pate, PMHNP-BC
• Aaroh Kalpesh Patel

• Community Based Hospice Care Agency in Lawrenceville, GA
• Providers in Lawrenceville, 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 Nov 2, 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.
• 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.