Pennyroyal Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

400012 Issued in KY

Legal business name

PENNYROYAL HOSPICE, INC.

Practice address

220 Burley Ave
Hopkinsville, KY 42240-8725

Phone

(270) 885-6428

Fax

(855) 270-7671

NPI assigned

Feb 2, 2006

Last updated

Jun 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Melony L Sandlin

Title

Office Manager

Phone

(270) 885-6428

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487626776. Details of each certification follow.

• CCN 181525 Hospice · Active · Details

Hospice certification: CCN 181525

Legal name

PENNYROYAL HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 18, 1992

Last certification

Feb 8, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationNon-profit

Incorporated

Apr 14, 1982 in KY

Enrollment address

220 Burley Ave
Hopkinsville, KY 42240-8725

Listed as

Pennyroyal HospiceCCN 181525 · All quality measures

Ownership

For-Profit

Certified

Feb 18, 1992

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Rebecca L Boggess, APRN

  • Primary Care Nurse Practitioner
  • Hopkinsville, KY
  • NPI 1861829830

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebecca L Boggess, APRN

  • Primary Care Nurse Practitioner
  • Hopkinsville, KY
  • NPI 1861829830
  Medicare reassignment NPD

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Geeta S Chavda, MD

  • Internal Medicine Physician
  • Hopkinsville, KY
  • NPI 1962477133

  Hospice

  Care Compare affiliation
• David Wayne French, M.D.

  • Family Medicine Physician
  • Eddyville, KY
  • NPI 1649336306

  Hospice

  Care Compare affiliation
• Ed Settle, M.D.

  • Family Medicine Physician
  • Princeton, KY
  • NPI 1871598581

  Hospice

  Care Compare affiliation
• Elizabeth A Toms, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Hopkinsville, KY
  • NPI 1912958554

  Hospice

  Care Compare affiliation
• Debra L. Wilder, M.D.

  • Family Medicine Physician
  • Kuttawa, KY
  • NPI 1174513915

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1487626776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 BURLEY AVE",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408725",
            "telephone_number": "270-885-6428",
            "fax_number": "855-270-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 BURLEY AVE",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422408725",
            "telephone_number": "270-885-6428",
            "fax_number": "855-270-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENNYROYAL HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "SANDLIN",
        "authorized_official_first_name": "MELONY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-885-6428",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KY",
            "license": "400012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44024016",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pennyroyal Services
• Holly Michelle Perez-Knight
• Francisco A Perez, RN
• Srinivasan Periyanayagam, MD
• Candice Perkins, FNP-BC

• Community Based Hospice Care Agency in Hopkinsville, KY
• Providers in Hopkinsville, KY by specialty
• Community Based Hospice Care Agency in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.