NPIMap

Organization Active NPI

Premier Hospice of Monroe, LLC

  • Community Based Hospice Care Agency
  • Monroe, LA
National Provider Identifier
1386834877
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PREMIER HOSPICE OF MONROE, LLC
Practice address
1651 Louisville Ave Ste 128
Monroe, LA 71201-6027
Phone
(318) 388-0555
Fax
(318) 388-0510
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Charles Goodwin Gladney Jr.
Title
Managing Partner
Phone
(318) 281-0000

Specialties & licenses 1

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

Addresses

Primary practice location

1651 Louisville Ave Ste 128
Monroe, LA 71201-6027

Mailing address

1523 Texas Ave
Bastrop, LA 71220-4043
Phone (318) 281-0000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080308000045 LA Part A Provider - Hospice 0345325874 Practice locations: Arcadia, LA

Hospice certification: CCN 191659

Legal name
PREMIER HOSPICE OF MONROE, LLC
Doing business as
PREMIER HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 26, 2008
Last certification
Feb 22, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jun 29, 2007 in LA
Enrollment address
600 Factory Outlet Dr
Suite 15
Arcadia, LA 71001-3057

Care Compare: Hospice

Medicare Care Compare
Listed as
Premier HospiceCCN 191659
Ownership
For-Profit
Certified
Mar 26, 2008
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Locations

600 Factory Outlet Dr
Ste 15
Arcadia, LA 71001
Phone (318) 579-5066

1800 Hudson Ln
Ste 2B
Monroe, LA 71201
Phone (318) 388-0555

1651 Louisville Ave
Ste 128
Monroe, LA 71201
Phone (318) 388-0555

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Charles Gladney Individual 5% Or Greater Indirect Ownership Interest Nov 7, 2007 25%
Corporate Director Nov 20, 2007
Cynthia Risinger Individual W-2 Managing Employee Nov 20, 2007
Delta Healthcare Management, LLC Organization, Bastrop, LA LLC 5% Or Greater Indirect Ownership Interest Jan 1, 2012
Operational/Managerial Control Jan 1, 2012 100%
Hospice Enterprises LLC Organization, Bastrop, LA LLC 5% Or Greater Indirect Ownership Interest Nov 20, 2007 58.3%
Operational/Managerial Control Nov 20, 2007
Melissa Maddox Individual W-2 Managing EmployeeAdministrator Jan 1, 2022
Premier Hospice LLC Organization, Bastrop, LA LLC, For-profit 5% Or Greater Direct Ownership Interest Nov 20, 2007 100%
Matthew Lyon Individual 5% Or Greater Direct Ownership Interest Nov 20, 2007
Corporate Director Nov 20, 2007

Owners & managing parties with NPI records 1

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

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 3

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": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1386834877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 TEXAS AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204043",
            "telephone_number": "318-281-0000",
            "fax_number": "318-281-2753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 LOUISVILLE AVE STE 128",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712016027",
            "telephone_number": "318-388-0555",
            "fax_number": "318-388-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER HOSPICE OF MONROE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "GLADNEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "GOODWIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "318-281-0000",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.