Homespun Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HOMESPUN HOSPICE LLC

Practice address

308 N Wall St
Calhoun, GA 30701-2224

Phone

(706) 383-2344

Fax

(706) 383-2269

NPI assigned

Jun 9, 2016

Last updated

Apr 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wendy Whittle

Title

Owner

Phone

(678) 986-7746

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558710541. Details of each certification follow.

• CCN 111786 Hospice · Active · Details

Hospice certification: CCN 111786

Legal name

HOMESPUN HOSPICE LLC

Doing business as

HOMESPUN HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 16, 2017

Last certification

Feb 27, 2020

Ownership / control type

Other

Organization structure

LLCProprietary

Incorporated

Mar 9, 2016 in GA

Enrollment address

308 N Wall St
Calhoun, GA 30701-2224

Listed as

Homespun Hospice, LLCCCN 111786 · All quality measures

Ownership

For-Profit

Certified

Mar 16, 2017

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 2

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

• Ted M Pennel, M.D.

  • Internal Medicine Physician
  • Calhoun, GA
  • NPI 1275556078

  W-2 Managing Employee

  CMS ownership
• William Leon Theus, MD

  • Surgery Physician
  • Calhoun, GA
  • NPI 1982708509

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership

Practitioners 1

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.

• Ted M Pennel, M.D.

  • Internal Medicine Physician
  • Calhoun, GA
  • NPI 1275556078
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ted M Pennel, M.D.

  • Internal Medicine Physician
  • Calhoun, GA
  • NPI 1275556078

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1558710541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N WALL ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012224",
            "telephone_number": "706-383-2344",
            "fax_number": "706-383-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N WALL ST",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307012224",
            "telephone_number": "706-383-2344",
            "fax_number": "706-383-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMESPUN HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "WHITTLE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-986-7746"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilary Thomas Hight III, M.D.
• Joel Benjamin Hoag, M.D.
• Sharon Michelle Holbrook, AGPCNP-BC
• Jackson Blake Holland, PHARMD
• Tina Miller Holt, NP-C
• Jerome Hooper, LPC
• Kelsey Elizabeth Hooper, FNP-C
• Kenneth Jerome Howard, MD
• HS Sleep Diagnostics Inc
• Jennifer Huffman, DPT

• Community Based Hospice Care Agency in Calhoun, GA
• Providers in Calhoun, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.