NPIMap

Organization Active NPI

LHCG Xcvii, LLC

Doing business as Baptist Hospice Union City

  • Community Based Hospice Care Agency
  • Union City, TN
National Provider Identifier
1477088177
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LHCG XCVII, LLC
Doing business as
Baptist Hospice Union City
Practice address
1201 Bishop St
Union City, TN 38261-5403
Phone
(731) 884-8617
Fax
(731) 884-8626
NPI assigned
May 1, 2017
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Donald D Stelly
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

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

Addresses

Primary practice location

1201 Bishop St
Union City, TN 38261-5403

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other names 1

  • Baptist Hospice Union City Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170803001024 TN Part A Provider - Hospice 0446521843 Practice locations: Union City, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477088177. Details of each certification follow.

Hospice certification: CCN 441577

Legal name
LHCG XCVII, LLC
Doing business as
BAPTIST HOSPICE UNION CITY
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 27, 1999
Last certification
Jul 28, 2021
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Jan 17, 2017 in TN
Enrollment address
1201 Bishop St
Union City, TN 38261-5403

Care Compare: Hospice

Medicare Care Compare
Listed as
Baptist Hospice Union CityCCN 441577 · All quality measures
Ownership
Other
Certified
May 27, 1999
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
44D2174884LHCG Xcvii1201 Bishop Street, Union City, TN 38261Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 67%
Baptist Memorial Home Care Inc Organization, Memphis, TN Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2017 33%
Marcus Donavon Macip Individual Corporate OfficerSecretary Feb 22, 2023
Kimberly Seymour Individual Corporate OfficerCfo/Treasurer Feb 22, 2023
LHCG Lxxxviii LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Jun 1, 2017 100%
William K Stone Individual W-2 Managing EmployeeMD; Oct 20, 2025
Tennessee Health Care Group LLC Organization, Lafayette, LA LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2017 67%
Jacquelyn Gabbert Individual W-2 Managing EmployeeExecutive Director Oct 25, 2025
Wendy S Daigle Individual Corporate OfficerDirector of Licensure Oct 1, 2022
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Jun 1, 2017 67%
Operational/Managerial Control Jun 1, 2017
Joshua Lee Proffitt Individual Corporate OfficerPresident Jun 1, 2017
Amy Cormier Individual Corporate DirectorDirector of Managed Care May 1, 2025

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 46

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

View all 46

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2017 Change of OwnershipThis provider was the buyer Baptist Home Care & HospiceCCN 441577, TN, NPI 1326123928

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

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": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1477088177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 BISHOP ST",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382615403",
            "telephone_number": "731-884-8617",
            "fax_number": "731-884-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG XCVII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Hospice Union City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union City, TN

Sources for this page

Verify at the official NPI Registry.