NPIMap

Organization Active NPI

Affinis Hospice, LLC

Doing business as Affinis Hospice

  • Community Based Hospice Care Agency
  • Augusta, GA
National Provider Identifier
1447536529
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AFFINIS HOSPICE, LLC
Doing business as
Affinis Hospice
Practice address
1365 Interstate Pkwy
Augusta, GA 30909-5626
Phone
(706) 434-0421
Fax
(706) 434-0427
NPI assigned
Nov 2, 2011
Last updated
Nov 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Mrs. Sarah A Thompson, RN, CHPN
Title
VP of Operations
Phone
(912) 538-8000

Specialties & licenses 1

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

Addresses

Primary practice location

1365 Interstate Pkwy
Augusta, GA 30909-5626

Mailing address

806 Maple Dr
Vidalia, GA 30474-7208
Phone (912) 538-8000

Other identifiers 2

IdentifierTypeStateIssuer
003156445AMedicaidGA
121-0401-HOtherGASTATE LICENSE

Other names 1

  • Affinis Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140610001719 GA Part A Provider - Hospice 1759579253 Practice locations: Augusta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447536529. Details of each certification follow.

Hospice certification: CCN 111748

Legal name
AFFINIS HOSPICE, LLC
Doing business as
AFFINIS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 28, 2014
Last certification
Oct 31, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
LLCNon-profit
Incorporated
Dec 9, 2009 in GA
Enrollment address
2945 Walton Way
Augusta, GA 30909-3827

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Affinis Hospice, LLCCCN 111748 · All quality measures
Ownership
Non-Profit
Certified
Aug 28, 2014
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
11D2080980Affinis Hospice, LLC2945 Walton Way, Augusta, GA 30909Certificate of waiverJul 16, 2028

National Provider Directory

National Provider Directory
Tax ID family
Affinis Hospice11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Member of 1

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

Ownership & related parties

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.

NameRoleSinceShare
Home and Community Services Inc Organization, Macon, GA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2021 100%
Dave a Ringer Individual Contracted Managing EmployeeMD; Sep 13, 2023
Mindy Wilcher Individual Corporate Director Oct 20, 2021 100%
Sarah a Thompson Individual Corporate DirectorDirector of Operations Feb 14, 2010 100%
W-2 Managing EmployeeDirector of Operations Feb 14, 2010 100%
Operational/Managerial ControlDirector of Operations Feb 14, 2010 100%

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 11

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1320192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1447536529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 MAPLE DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747208",
            "telephone_number": "912-538-8000",
            "fax_number": "912-538-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095626",
            "telephone_number": "706-434-0421",
            "fax_number": "706-434-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINIS HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-02",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "912-538-8000",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003156445A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "121-0401-H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affinis Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Affinis Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.