Comfort Care Hospice

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

001-346-H Issued in GA

Legal business name

COMFORT CARE HOSPICE

Practice address

88 Heritage St
Baxley, GA 31513-0012

Phone

(912) 367-4146

Fax

(912) 367-4147

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Angie Deloris Potts, RN BSN

Title

Owner/Administrator

Phone

(912) 367-4146

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 111720

Legal name

COMFORT CARE HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 27, 2012

Last certification

Apr 7, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Mar 12, 2008 in GA

Enrollment address

88 Heritage St
Baxley, GA 31513-0012

Listed as

Comfort Care HospiceCCN 111720

Ownership

For-Profit

Certified

Feb 27, 2012

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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 2

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

• Michael S. Deen, M.D.

  • Family Medicine Physician
  • Alma, GA
  • NPI 1154429991

  Contracted Managing Employee

  CMS ownership
• Orlando V Fernando, M.D.

  • Internal Medicine Physician
  • Baxley, GA
  • NPI 1982663381

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 3

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

• Michael S. Deen, M.D.

  • Family Medicine Physician
  • Alma, GA
  • NPI 1154429991

  Hospice

  Care Compare affiliation
• Orlando V Fernando, M.D.

  • Internal Medicine Physician
  • Baxley, GA
  • NPI 1982663381

  Hospice

  Care Compare affiliation
• Michael Todd Peacock, M.D.

  • Internal Medicine Physician
  • Eastman, GA
  • NPI 1487636742

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1487935672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 HERITAGE ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130012",
            "telephone_number": "912-367-4146",
            "fax_number": "912-367-4147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 HERITAGE ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315130012",
            "telephone_number": "912-367-4146",
            "fax_number": "912-367-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMFORT CARE HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "POTTS",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "DELORIS",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "912-367-4146",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "001-346-H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rendi M Carter, LCSW
• Amy Nicole Causey, P.A.-C
• Certified Respiratory Services,Inc.
• David M Cheney, M.D.
• Walt Collins
• Consultants in Pain Medicine, LLC
• Jerry Allen Copeland
• Deidra Phillips Corbitt, LCSW
• Stephanie Cothern, FNP-BC
• John E Crane, MD

• Community Based Hospice Care Agency in Baxley, GA
• Providers in Baxley, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.