Organization Active NPI

Hope Hospice of Atlanta, Inc

  • Community Based Hospice Care Agency
  • Dallas, GA
National Provider Identifier
1528455169
Registry record updated Apr 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOPE HOSPICE OF ATLANTA, INC
Practice address
300 W I Pkwy
Suite 208
Dallas, GA 30132-5079
Phone
(770) 694-6750
Fax
(770) 818-5720
NPI assigned
Apr 21, 2015
Last updated
Apr 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2015

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

Authorized official

Name
Mr. Stanley NjokuNPI 1760347405
Title
Chief Executive Officer
Phone
(770) 694-6750

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

300 W I Pkwy
Suite 208
Dallas, GA 30132-5079

Mailing address

300 W I Pkwy
Suite 208
Dallas, GA 30132-5079
Phone (770) 694-6750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150903000530 GA Part A Provider - Hospice 2769798883 Practice locations: Hiram, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528455169. Details of each certification follow.

Hospice certification: CCN 111770

Legal name
HOPE HOSPICE OF ATLANTA, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 24, 2015
Last certification
Sep 2, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 22, 2014 in GA
Enrollment address
5604 Wendy Bagwell Pkwy
Ste 422
Hiram, GA 30141-7815

Care Compare: Hospice

Medicare Care Compare
Listed as
Hope Hospice of AtlantaCCN 111770 · All quality measures
Ownership
For-Profit
Certified
Nov 24, 2015
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
11D2103326Hope Hospice of Atlanta, LLC5604 Wendy Bagwell Parkway, Suite 422, Hiram, GA 30141Certificate of waiverOct 8, 2027

National Provider Directory

National Provider Directory

Locations

300 W I Pkwy
Ste 208
Dallas, GA 30132
Phone (404) 853-9316

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
Stanley C. Njoku Individual 5% Or Greater Direct Ownership InterestCeo Jul 22, 2014 100%
Corporate OfficerCeo Jul 22, 2014 33.33%
W-2 Managing EmployeeAd;Ceo Jul 22, 2014 33.33%
James Rogan Individual Contracted Managing EmployeeMD; Jun 27, 2017

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

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.

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": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429574400000",
    "number": "1528455169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W I PKWY",
            "address_2": "SUITE 208",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325079",
            "telephone_number": "770-694-6750",
            "fax_number": "770-818-5720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W I PKWY",
            "address_2": "SUITE 208",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301325079",
            "telephone_number": "770-694-6750",
            "fax_number": "770-818-5720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE HOSPICE OF ATLANTA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2015-04-21",
        "status": "A",
        "authorized_official_last_name": "NJOKU",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-694-6750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.