Organization Active NPI

1St Care Hospice Inc

  • Community Based Hospice Care Agency
  • South Boston, VA
National Provider Identifier
1518672658
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
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

Updated by the provider on Nov 20, 2023

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
HSP-23453MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
CorporationProprietary
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 IncCCN 491658 · All quality measures
Certified
Sep 1, 2023
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
49D22776081St Care Hospice, Inc425 Main Street, South Boston, VA 24592Certificate of waiverMar 1, 2027

National Provider Directory

National Provider Directory

Ownership & 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.

NameRoleSinceShare
Alfred Lee Burkholder Individual 5% Or Greater Direct Ownership InterestPresident Jul 13, 2022 100%
Corporate OfficerPresident Jul 13, 2022 100%
Corporate DirectorPresident Jul 13, 2022 100%
W-2 Managing EmployeePresident Jul 13, 2022 100%
Operational/Managerial ControlPresident Jul 13, 2022 100%
First Care Health Services, Inc. Organization, South Boston, VA Corporation 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.

Practitioners & affiliated clinicians

Practitioners 3

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

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

Verify at the official NPI Registry.