Active NPI
1St Care Hospice Inc
- Community Based Hospice Care Agency
- South Boston, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- 1ST CARE HOSPICE INC
- Practice address
- 425 Main St
South Boston, VA 24592-3241 - Phone
- (434) 572-0063
- NPI assigned
- Jan 23, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alfred Lee Burkholder III
- Title
- President
- Phone
- (434) 572-1582
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
425 Main St
South Boston, VA 24592-3241
Mailing address
PO Box 1006
South Boston, VA 24592-1006
Phone (434) 572-1582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HSP-23453 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230522002655 | VA | Part A Provider - Hospice | 1254797988 | Practice locations: South Boston, VA |
Hospice certification: CCN 491658
- Legal name
- 1ST CARE HOSPICE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 1, 2023
- Last certification
- Aug 4, 2023
- Organization structure
- Corporation
- Incorporated
- Jul 13, 2022 in VA
- Enrollment address
- 425 Main St
South Boston, VA 24592-3241
Care Compare: Hospice
Medicare Care Compare- Listed as
- 1St Care Hospice Inc
- Certified
- Sep 1, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2277608 | 1St Care Hospice, Inc | Certificate of waiver | Mar 1, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Alfred Lee Burkholder | 5% Or Greater Direct Ownership Interest | Jul 13, 2022 | 100% |
| Corporate Officer | Jul 13, 2022 | 100% | |
| Corporate Director | Jul 13, 2022 | 100% | |
| W-2 Managing Employee | Jul 13, 2022 | 100% | |
| Operational/Managerial Control | Jul 13, 2022 | 100% | |
| First Care Health Services, Inc. | Operational/Managerial Control | Jul 13, 2022 | 100% |
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Home Health Agency
- South Boston, VA
- NPI 1487646113
First Care Health Services, Inc.
-
- Home Health Agency
- Lynchburg, VA
- NPI 1922090687
First Care Health Services, Inc.
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Emergency Medicine Physician
- South Boston, VA
- NPI 1255655825
-
- Family Nurse Practitioner
- Nathalie, VA
- NPI 1720352354
-
- Family Nurse Practitioner
- South Boston, VA
- NPI 1619370087
Affiliated clinicians 1
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": "1674432000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700438400000",
"number": "1518672658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1006",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245921006",
"telephone_number": "434-572-1582",
"fax_number": "434-572-2631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 MAIN ST",
"city": "SOUTH BOSTON",
"state": "VA",
"postal_code": "245923241",
"telephone_number": "434-572-0063"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "1ST CARE HOSPICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-01-23",
"last_updated": "2023-11-20",
"certification_date": "2023-11-20",
"status": "A",
"authorized_official_last_name": "BURKHOLDER",
"authorized_official_first_name": "ALFRED",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "434-572-1582",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HSP-23453",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in South Boston, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.