Organization Active NPI

Hospice Advantage, LLC.

Doing business as Compassus - Mid Mississippi

  • Community Based Hospice Care Agency
  • Brookhaven, MS
National Provider Identifier
1386930113
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
140 Issued in MS
Legal business name
HOSPICE ADVANTAGE, LLC.
Doing business as
Compassus - Mid Mississippi
Practice address
120 W Cherokee St
Brookhaven, MS 39601
Phone
(601) 849-5903
Fax
(601) 849-5346
NPI assigned
Jun 20, 2011
Last updated
Oct 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

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

Authorized official

Name
Russell Adkins
Title
SVP General Counsel
Phone
(615) 309-5668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 140 MS Primary

Addresses

Primary practice location

120 W Cherokee St
Brookhaven, MS 39601

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (417) 841-4834

Other names 1

  • Compassus - Mid Mississippi Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110823000579 MS Part A Provider - Hospice 3779544960 Practice locations: Brookhaven, MS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386930113. Details of each certification follow.

Hospice certification: CCN 251637

Legal name
HOSPICE ADVANTAGE LLC
Doing business as
COMPASSUS-MID-MISSISSIPPI
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 1, 2006
Last certification
Jun 1, 2012
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Sep 8, 2004 in FL
Enrollment address
120 W Cherokee St
Brookhaven, MS 39601-3311

Care Compare: Hospice

Medicare Care Compare
Listed as
Compassus-Mid-MississippiCCN 251637 · All quality measures
Ownership
For-Profit
Certified
Dec 1, 2006
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
25D1056213Compassus - Mid Mississippi120 W Cherokee Street, Brookhaven, MS 39601Certificate of waiverJul 9, 2028

National Provider Directory

National Provider Directory
Tax ID family
Compassus Allentown37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

Member of 1

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

Locations

401 Center Ave
Bay City, MI 48708
Phone (248) 629-9829

120 W Cherokee St
Brookhaven, MS 39601
Phone (601) 835-3363

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Compassus Parent, Inc. Organization, New York, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 100%
FC Compassus LLC Organization, Brentwood, TN LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2015 100%
Washington State Investment Board Organization, Olympia, WA For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 5.24%
Russell G Adkins Individual Corporate OfficerGeneral Counsel, Sr VP and Sec Oct 7, 2015
Operational/Managerial Control Oct 7, 2015
Melissa D Renfroe Individual W-2 Managing EmployeeArea Executive Clinical Operations Aug 13, 2020
David F Grams Individual Corporate OfficerCeo Jan 31, 2022
Ti V ASC Compassus Investment Aggregator, L.P. Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 99%
Michael Kirkbride Individual Corporate OfficerDivision President Jan 3, 2022
Ascension Towerbrook Healthcare Opportunities LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 49.5%
Compassus Holdings LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 100%
Community Hospices of America, LLC. Organization, Brentwood, TN LLC, For-profit Operational/Managerial Control Jan 6, 2020
Ti V Compassus Investment Aggregator, L.P. Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 49.5%
Hospice Advantage Midco LLC Organization, Brentwood, TN Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Oct 7, 2015 100%
Towerbrook Investors V (Onshore) LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 29.75%
Hospice Advantage Holdings, LLC Organization, Brentwood, TN Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2015 100%
Ascension Capital LLC Organization, Clayton, MO LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019
Towerbrook Investors V (892), L.P. Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 14.14%
FC Compassus Hospice Blocker, LLC Organization, Brentwood, TN Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 7, 2015 13%
Ascension Health Alliance Organization, Clayton, MO Non-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019
Compassus Intermediate, Inc. Organization, New York, NY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Dec 31, 2019 100%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compassus-FlorenceFlorence, AL, CCN 011678 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Compassus- North Georgia IIEast Ellijay, GA, CCN 111682 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 7, 2015
Compassus - AuburnAuburn, AL, CCN 011528 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012

Facilities with the same owner 166

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

View all 166

Practitioners & affiliated clinicians

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": "1308528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1386930113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "417-841-4834",
            "fax_number": "866-995-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W CHEROKEE ST",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "39601",
            "telephone_number": "601-849-5903",
            "fax_number": "601-849-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE ADVANTAGE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-20",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP GENERAL COUNSEL",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus - Mid Mississippi",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookhaven, MS

Sources for this page

Verify at the official NPI Registry.