Primecare Hospice & Palliative Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PRIMECARE HOSPICE & PALLIATIVE INC

Practice address

1735 Irwinton Rd Ste 1a
Milledgeville, GA 31061-3830

Phone

(770) 755-1972

Fax

(478) 451-0224

NPI assigned

Feb 12, 2017

Last updated

Jul 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

Caleb Flournoy

Title

Coo

Phone

(770) 755-1972

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 1427597350. Details of each certification follow.

• CCN 851597 Hospice · Active · Details

Hospice certification: CCN 851597

Legal name

PRIMECARE HOSPICE & PALLIATIVE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 13, 2024

Last certification

May 24, 2024

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 14, 2021 in GA

Enrollment address

1735 Irwinton Rd
Ste 1a
Milledgeville, GA 31061-3830

Listed as

Primecare Hospice & Palliative, IncCCN 851597 · All quality measures

Certified

Jun 13, 2024

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 4

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.

• Ralph Austin Jr., MD

  • Family Medicine Physician
  • Macon, GA
  • NPI 1093758294

  Contracted Managing Employee

  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.

• Sherian Alecia Sharomi

  • Clinical Social Worker
  • Norcross, GA
  • NPI 1972838365
  NPD

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

{
    "created_epoch": "1486857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688256000000",
    "number": "1427597350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 IRWINTON RD STE 1A",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613830",
            "telephone_number": "770-755-1972",
            "fax_number": "478-451-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 IRWINTON RD STE 1A",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310613830",
            "telephone_number": "770-755-1972",
            "fax_number": "478-451-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE HOSPICE & PALLIATIVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-12",
        "last_updated": "2023-07-02",
        "certification_date": "2023-07-02",
        "status": "A",
        "authorized_official_last_name": "FLOURNOY",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "770-755-1972"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Milledgeville, GA
• Providers in Milledgeville, 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 Jul 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.