Sovereign Hospice Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOVEREIGN HOSPICE INC.

Practice address

5675 Jimmy Carter Blvd Ste 100B
Norcross, GA 30071-4666

Phone

(470) 223-3773

Fax

(404) 991-3662

NPI assigned

Jul 29, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Enid Jean Wright, RN CHPN

Title

President

Phone

(770) 687-1232

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 111766

Legal name

SOVEREIGN HOSPICE INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 27, 2015

Last certification

Jun 22, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 14, 2014 in GA

Enrollment address

6065 Roswell Rd
Ste 520
Sandy Springs, GA 30328-4015

Listed as

Sovereign HospiceCCN 111766 · All quality measures

Ownership

For-Profit

Certified

Aug 27, 2015

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

Locations

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.

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1548678923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 JIMMY CARTER BLVD STE 100B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714666",
            "telephone_number": "470-223-3773",
            "fax_number": "404-991-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 JIMMY CARTER BLVD STE 100B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300714666",
            "telephone_number": "470-223-3773",
            "fax_number": "404-991-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HOSPICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "ENID",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-687-1232",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.