NPIMap

Organization Active NPI

Odyssey Healthcare Operating a, LP

  • Community Based Hospice Care Agency
  • Russellville, AR
National Provider Identifier
1467802405
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ODYSSEY HEALTHCARE OPERATING A, LP
Practice address
3801 W Main St Ste a
Russellville, AR 72801-2313
Phone
(479) 219-6211
Fax
(479) 890-2563
NPI assigned
Jun 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Janet Combs
Title
VP of Licensure
Phone
(704) 664-2876

Specialties & licenses 1

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

Addresses

Primary practice location

3801 W Main St Ste a
Russellville, AR 72801-2313

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 664-2876

Other practice location 1

295 Featherston St
Waldron, AR 72958-8900
Phone (479) 637-0703

Other identifiers 1

IdentifierTypeStateIssuer
216624747MedicaidAR

Other names 1

  • Gentiva Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220601001033 AR Part A Provider - Hospice 4385551035 Practice locations: Russellville, AR; Waldron, AR

Hospice certification: CCN 041528

Legal name
ODYSSEY HEALTHCARE OPERATING A LP
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 23, 1992
Last certification
Apr 20, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
PartnershipProprietary
Incorporated
Mar 11, 1998 in DE
Enrollment address
3801 W Main St
Ste a
Russellville, AR 72801-2313

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 041528
Ownership
For-Profit
Certified
Dec 23, 1992
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
04D2118685Gentiva3801 W Main Street Ste a, Russellville, AR 72801Certificate of waiverSep 12, 2026

National Provider Directory

National Provider Directory
Tax ID family
Odyssey Healthcare Operating a LP41 organizations share this tax ID, including this one

Other organizations with this tax ID 40

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

View all 40

Member of 2

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

Ownership & related parties

All disclosed owners & managing parties 25

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

NameRoleSinceShare
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%
Kentucky Homecare Parent Inc. Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerSecretary, General Counsel and B Apr 27, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%
David Robinson Arnold Individual Corporate OfficerVP and Controller Dec 31, 2021
OtherChain Home Administrator Dec 31, 2021
Heather L Adney Individual W-2 Managing EmployeeAd; Sep 15, 2020
Odyssey Healthcare Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Thomas Joseph Dolan Individual Corporate OfficerCfo Nov 30, 2021
Charlotte Midco, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Louisville, KY Corporation, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Odyssey Healthcare LP, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Direct Ownership Interest Feb 1, 2018 99%
Limited Partnership Interest Feb 1, 2016 99%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Limited Partnership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerCeo Apr 27, 2021
Charlotte Buyer, Inc. Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Other Mar 1, 2022 100%
Odyssey Healthcare Holding Company Organization, Atlanta, GA Holding company, For-profit 5% Or Greater Indirect Ownership Interest Feb 1, 2016 100%
Odyssey Healthcare GP, LLC Organization, Atlanta, GA LLC, For-profit General Partnership Interest Feb 1, 2016 1%
Janet L Combs Individual Corporate OfficerVP of Licensing Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY Holding company, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Limited Partnership Interest Aug 11, 2022 60%
Centerwell Health Services Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%
Charles C Scott Individual Contracted Managing EmployeeMD; Nov 27, 2019
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest May 1, 2022 100%

Owners & managing parties with NPI records 36

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

View all 36

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
GentivaHarlingen, TX, CCN 451667 Hospice 5% Or Greater Direct Ownership Interest (100%) Feb 1, 2016

Facilities with the same owner 196

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

View all 196

Change-of-ownership history 2

DateEventCounterparty
May 1, 2022 Change of OwnershipThis provider was the buyer Kindred Hospice ICCN 041528, AR, NPI 1467802405
May 1, 2022 Change of OwnershipThis provider was the seller GentivaCCN 041528, AR, NPI 1467802405

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1467802405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "telephone_number": "704-664-2876",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 W MAIN ST STE A",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012313",
            "telephone_number": "479-219-6211",
            "fax_number": "479-890-2563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "295 Featherston St",
            "address_purpose": "LOCATION",
            "city": "Waldron",
            "state": "AR",
            "postal_code": "729588900",
            "country_code": "US",
            "telephone_number": "479-637-0703",
            "fax_number": "844-658-2867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ODYSSEY HEALTHCARE OPERATING A, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-664-2876"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216624747",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.