NPIMap

Organization Active NPI

Hospice Savannah, Inc

  • Community Based Hospice Care Agency
  • Savannah, GA
National Provider Identifier
1508812447
Registry record updated Feb 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICE SAVANNAH, INC
Practice address
1352 Eisenhower Dr
Savannah, GA 31406-3902
Phone
(912) 355-2289
Fax
(912) 355-2376
NPI assigned
May 25, 2006
Last updated
Feb 21, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2024

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

Authorized official

Name
Kathleen Deloach Benton
Title
Ceo
Phone
(912) 629-1020

Specialties & licenses 1

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

Addresses

Primary practice location

1352 Eisenhower Dr
Savannah, GA 31406-3902

Mailing address

1352 Eisenhower Dr
Savannah, GA 31406-3902
Phone (912) 355-2289

Other identifiers 1

IdentifierTypeStateIssuer
00371764AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040707000377 GA Part B Supplier - Clinic/Group Practice 0244217248 Receives reassigned benefits from 16 practitioners
Practice locations: Savannah, GA
O20050824000563 GA Part A Provider - Hospice 0244217248 Practice locations: Savannah, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508812447. Details of each certification follow.

Hospice certification: CCN 111504

Legal name
HOSPICE SAVANNAH, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 24, 1984
Last certification
Mar 10, 2021
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Enrollment address
1352 Eisenhower Drive
Savannah, GA 31416-3902

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice SavannahCCN 111504 · All quality measures
Ownership
Other
Certified
Jan 24, 1984
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
11D0912299Hospice Savannah Inc1352 Eisenhower Dr, Savannah, GA 31416Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Kathleen Benton Individual Corporate OfficerCeo Jan 1, 2019 100%
W-2 Managing EmployeeCeo Jan 1, 2019 100%

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

Affiliated clinicians 4

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": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1508812447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063902",
            "telephone_number": "912-355-2289",
            "fax_number": "912-355-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1352 EISENHOWER DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063902",
            "telephone_number": "912-355-2289",
            "fax_number": "912-355-2376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE SAVANNAH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "BENTON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "DELOACH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-629-1020"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00371764A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.