Faith Hospice of the Ozarks LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

LC001451455 Issued in MO

Legal business name

FAITH HOSPICE OF THE OZARKS LLC

Practice address

123 Johnstown Dr
Rogersville, MO 65742-9366

Phone

(417) 753-7757

Fax

(417) 753-7757

NPI assigned

Jul 25, 2015

Last updated

Jun 20, 2016By 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

Gayla Rae Manary, RN, CHPNNPI 1386017622

Title

Administrator/Owner

Phone

(417) 840-7776

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508241001. Details of each certification follow.

• CCN 261665 Hospice · Active · Details

Hospice certification: CCN 261665

Legal name

FAITH HOSPICE OF THE OZARKS LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 27, 2016

Last certification

Mar 30, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jun 21, 2015 in MO

Enrollment address

123 Johnstown Dr
Rogersville, MO 65742-9366

Listed as

Faith Hospice of the Ozarks, LLCCCN 261665 · All quality measures

Ownership

For-Profit

Certified

May 27, 2016

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

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.

Practitioners 4

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.

• Gayla Manary

  • Community Health Worker
  • Rogersville, MO
  • NPI 1386017622
  NPD Authorized official
• Carl D. Claxton, D.O.

  • Family Medicine Physician
  • Springfield, MO
  • NPI 1114035367
  NPD
• Dennis Kenyon, M.D.

  • General Practice Physician
  • Springfield, MO
  • NPI 1467433300
  NPD (past)
• Rebecca Jean McAtee, FNP-C

  • Family Nurse Practitioner
  • Rogersville, MO
  • NPI 1437563996
  NPD (past)

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

{
    "created_epoch": "1437782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466380800000",
    "number": "1508241001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 JOHNSTOWN DR",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429366",
            "telephone_number": "417-753-7757",
            "fax_number": "417-753-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 JOHNSTOWN DR",
            "city": "ROGERSVILLE",
            "state": "MO",
            "postal_code": "657429366",
            "telephone_number": "417-753-7757",
            "fax_number": "417-753-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH HOSPICE OF THE OZARKS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-25",
        "last_updated": "2016-06-20",
        "status": "A",
        "authorized_official_last_name": "MANARY",
        "authorized_official_first_name": "GAYLA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "417-840-7776",
        "authorized_official_credential": "RN, CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "LC001451455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "261665",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE JOINT COMMISSION ACCREDITATION",
            "identifier": "581530",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Rose Davison, FNP-BC
• Oakley B. Downing, M.D.
• Odilia Egbers
• Elect Independence LLC (Elect Home Care)
• Equi-Librium Therapy Center
• Faith Palliative Care
• Family Pharmacy of Missouri LLC (Family Pharmacy #5)
• Family Pharmacy Partnership
• Jerald Delbert Forsyth, PSY.D.
• Aaron Francis

• Community Based Hospice Care Agency in Rogersville, MO
• Providers in Rogersville, MO by specialty
• Community Based Hospice Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.