NPIMap

Organization Active NPI

Northeast Georgia Medical Center., Inc.

Doing business as Hospice of Northeast Georgia Medical Center

  • Community Based Hospice Care Agency
  • Gainesville, GA
National Provider Identifier
1457388571
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
NORTHEAST GEORGIA MEDICAL CENTER., INC.
Doing business as
Hospice of Northeast Georgia Medical Center
Practice address
2150 Limestone Pkwy
Suite 222
Gainesville, GA 30501-2567
Phone
(770) 219-8888
Fax
(770) 219-6694
NPI assigned
Jun 26, 2006
Organization subpart
Yes
Parent organization
NORTHEAST GEORGIA MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Authorized official

Name
Brian D Steines
Title
Cfo
Phone
(770) 219-3562

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X GA Primary
Inpatient Hospice 315D00000X

Addresses

Primary practice location

2150 Limestone Pkwy
Suite 222
Gainesville, GA 30501-2567

Mailing address

2150 Limestone Pkwy
Suite 222
Gainesville, GA 30501-2567
Phone (770) 219-8888

Other identifiers 1

IdentifierTypeStateIssuer
00371324AMedicaidGA

Other names 1

  • HOSPICE OF NORTHEAST GEORGIA MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080317000084 GA Part A Provider - Hospice 7517953755 Practice locations: Gainesville, GA

Hospice certification: CCN 111514

Legal name
NORTHEAST GEORGIA MEDICAL CENTER, INC.
Doing business as
HOSPICE OF NE GA MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 30, 1986
Last certification
Oct 25, 2019
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Nov 17, 1997 in GA
Enrollment address
2150 Limestone Pkwy 222
Gainesville, GA 30501-2567

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Northeast Ga MCCCN 111514 · All quality measures
Ownership
Other
Certified
Dec 30, 1986
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Northeast Ga Med Center11 organizations share this tax ID, including this one
Part of
Northeast Ga Med Center

Other organizations with this tax ID 10

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

Locations

2150 Limestone Pkwy
Ste 222
Gainesville, GA 30501
Phone (770) 219-0063

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
Alexander a. Wayne Individual Corporate DirectorBoard Member Feb 1, 2014
Steven F. Blair Individual Corporate DirectorBoard Member Feb 1, 2014
Ronald C Lewis Individual Corporate DirectorBoard Member Feb 1, 2014
Northeast Georgia Health System Organization, Gainesville, GA Operational/Managerial Control Nov 26, 2007
Lua R. Blankenship Individual Corporate DirectorBoard Member Feb 1, 2014
Brian D Steines Individual Corporate OfficerChief Financial Officer Jul 5, 2017 100%
W-2 Managing Employee Jul 5, 2017
Rodney Smith Individual Corporate Director Nov 26, 2007
Robert P. Bowen Individual Corporate DirectorBoard Member Feb 1, 2014
Linda Nicholson Individual W-2 Managing Employee Nov 26, 2007
Larry E. Dent Individual Corporate DirectorBoard Member Feb 1, 2014
Carol Burrell Individual W-2 Managing Employee Nov 26, 2007
Jeffrey C Terry Individual Corporate DirectorBoard Feb 1, 2014
Jay S Hortenstine Individual Corporate DirectorBoard Member Feb 1, 2014
Timothy a Scully Individual Corporate DirectorBoard Member Feb 1, 2014
Kaye a. Hearth Individual Corporate DirectorBoard Member Feb 1, 2014
Jack B. Keener Individual Corporate DirectorBoard Member Feb 1, 2014
Deborah K. Mack Individual Corporate DirectorBoard Member Feb 1, 2014
Anthony M. Herdener Individual Corporate Director Nov 26, 2007
Jane B. Smoot Individual Corporate DirectorBoard Member Feb 1, 2014
Jacquelyn L. Wallace Individual Corporate DirectorBoard Member Feb 1, 2014

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Northeast Georgia Rehabilitation InstituteGainesville, GA, CCN 113039 Hospital 5% Or Greater Direct Ownership Interest (51%) Jun 3, 2025
New Horizons Lanier ParkGainesville, GA, CCN 115487 Skilled nursing facility Operational/Managerial Control (100%) Feb 4, 2008

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1457388571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 LIMESTONE PKWY",
            "address_2": "SUITE 222",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012567",
            "telephone_number": "770-219-8888",
            "fax_number": "770-219-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 LIMESTONE PKWY",
            "address_2": "SUITE 222",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012567",
            "telephone_number": "770-219-8888",
            "fax_number": "770-219-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER., INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST GEORGIA MEDICAL CENTER, INC.",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-219-3562"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00371324A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HOSPICE OF NORTHEAST GEORGIA MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HOSPICE OF NORTHEAST GEORGIA MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.