Appalachian Hospice South LLC

Organization Active NPI Hospice and Palliative Medicine (Internal Medicine) Physician · Jasper, GA

NPI 1497536098 · NPPES record last updated Oct 10, 2023

Key facts

NPI
1497536098
Entity type
Organization (NPI type 2)
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X
Legal business name
APPALACHIAN HOSPICE SOUTH LLC
Practice address
12 Sammy McGhee Blvd Ste 202
Jasper, GA 30143-7712
Phone
(706) 253-4015
Fax
(706) 253-4021
NPI assigned
Oct 10, 2023
Organization subpart
No

Authorized official

Name
Gary William Rasmussen
Title
President
Phone
(706) 253-4015

Other NPIs with the same Medicare PAC ID 1

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.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20240430001427 GA Part B Supplier - Clinic/Group Practice 2365897956 Receives reassigned benefits from 6 practitioners
Practice locations: Jasper, GA

National Provider Directory

Tax ID family
Appalachian Hospice (2 organizations share this tax ID)

Locations

1201 Dews Pond Rd SE
Ste 7
Calhoun, GA 30701
Phone (706) 253-4015

377 Mountain Blvd S
Ste 102
Jasper, GA 30143
Phone (706) 253-4015

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RH0002X Yes

Addresses

Primary practice location

12 Sammy McGhee Blvd Ste 202
Jasper, GA 30143-7712

Mailing address

1346 Pat Haralson Dr
Blairsville, GA 30512-8410
Phone (706) 781-0924

Other names

  • Appalachian Palliative Care Doing business as

Other providers in Jasper, GA

All providers in Jasper, GA · Hospice and Palliative Medicine (Internal Medicine) Physician in Georgia

Sources for this page

Verify at the official NPI Registry.