NPIMap

Organization Active NPI

Covenant Homecare

  • Community Based Hospice Care Agency
  • Knoxville, TN
National Provider Identifier
1467449181
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0000000364 Issued in TN
Legal business name
COVENANT HOMECARE
Practice address
3001 Lake Brook Blvd
Suite 101
Knoxville, TN 37909-1100
Phone
(865) 374-0600
Fax
(865) 374-2061
NPI assigned
Sep 29, 2005
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. John Huskey
Title
Chief Executive Officer
Phone
(865) 374-0602

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 1

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

Facilities with the same owner 14

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

Practitioners 16

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.

Care Compare: Hospice

Medicare Care Compare
Listed as
Covenant HospiceCCN 441542
Ownership
Non-Profit
Certified
Nov 15, 1993
Medicare certification status
Active (Provider of Services file)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Hospice certification: CCN 441542

Medicare enrollment files
Legal name
COVENANT HOMECARE
Doing business as
COVENANT HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 15, 1993
Last certification
Aug 3, 2017
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Mar 3, 1995 in TN
Enrollment address
3001 Lake Brook Blvd
Suite 101
Knoxville, TN 37909-1178

All disclosed owners & managing parties 7

Medicare enrollment files

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

NameRoleSinceShare
Gina W Hollenbeck Individual Corporate DirectorHospice Director Nov 1, 2023
W-2 Managing Employee Nov 1, 2023
Amy Delong Individual Corporate OfficerVice President/Controller Mar 4, 2024
Covenant Health Organization, Knoxville, TN Non-profit 5% Or Greater Direct Ownership Interest Mar 15, 2008 100%
Operational/Managerial Control Mar 15, 2008
Joseph Christopher Dolan Individual Corporate OfficerEvp/Cfo Jul 31, 2023
John Huskey Individual Corporate OfficerPresident/Cao Jan 1, 2003
W-2 Managing EmployeePresident/Cao Dec 1, 1997
James Vandersteeg Individual Corporate OfficerCovenant Health President/Ceo Apr 1, 2016 100%
Mitzi Anderson Individual Corporate OfficerCfo May 31, 2015
W-2 Managing Employee May 31, 2015

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20090317000047 TN Part a Provider - Hospice 0749282010 Practice locations: Morristown, TN; Knoxville, TN
O20120517000311 TN Part B Supplier - Clinic/Group Practice 0749282010 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Knoxville, TN; Sevierville, TN; Oak Ridge, TN; Morristown, TN; Lenoir City, TN; Harriman, TN

National Provider Directory

National Provider Directory
Tax ID family
Covenant Homecare (2 organizations share this tax ID)

Locations

3003 Lake Brook Blvd
Ste 101
Knoxville, TN 37909

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0000000364 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

3001 Lake Brook Blvd
Suite 101
Knoxville, TN 37909-1100

Mailing address

3001 Lake Brook Blvd
Suite 101
Knoxville, TN 37909-1100
Phone (865) 374-0600

Other identifiers 6

NPPES NPI Registry
IdentifierTypeStateIssuer
0152215MedicaidTN
195889OtherTNBLUE CROSS / BLUE SHIELD
7868433OtherTNAETNA
070036899OtherTNEEOICPA
100020421MedicaidTN
702002369OtherTNCARITEN

Other names 1

NPPES NPI Registry
  • Covenant HomeCare Hospice Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 18, 2014.

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1467449181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 LAKE BROOK BLVD",
            "address_2": "SUITE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091100",
            "telephone_number": "865-374-0600",
            "fax_number": "865-374-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 LAKE BROOK BLVD",
            "address_2": "SUITE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091100",
            "telephone_number": "865-374-0600",
            "fax_number": "865-374-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "HUSKEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "865-374-0602",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TN",
            "license": "0000000364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0152215",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "195889",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7868433",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EEOICPA",
            "identifier": "070036899",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100020421",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARITEN",
            "identifier": "702002369",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant HomeCare Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.