NPIMap

Organization Active NPI

Hospice of Davidson County North Carolina, Inc.

  • Community Based Hospice Care Agency
  • Lexington, NC
National Provider Identifier
1568415271
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOS0372 Issued in NC
Legal business name
HOSPICE OF DAVIDSON COUNTY NORTH CAROLINA, INC.
Practice address
200 Hospice Way
Lexington, NC 27292-6989
Phone
(336) 475-5444
Fax
(336) 474-2080
NPI assigned
May 17, 2006
Organization subpart
No

Owners & managing parties with NPI records 2

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

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 4

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

Affiliated clinicians 21

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

View all 21

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Davidson County/ Hinkle Hospice HouseCCN 341553
Ownership
Non-Profit
Certified
May 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090403000446 NC Part A Provider - Hospice 4385791581 Practice locations: Lexington, NC

Hospice certification: CCN 341553

Legal name
HOSPICE OF DAVIDSON COUNTY NORTH CAROLINA INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 1, 1991
Last certification
Dec 8, 2006
Ownership / control type
Non-Profit - Private
Organization structure
CorporationProprietary
Incorporated
May 25, 1984 in NC
Enrollment address
200 Hospice Way
Lexington, NC 27292-6989

All disclosed owners & managing parties 16

Medicare enrollment files

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

NameRoleSinceShare
Debbie C, Fanary Individual Corporate DirectorBoard Member Jan 1, 2025
Michelle Murphy Cecil Individual Corporate DirectorBoard Member Jan 1, 2024
Daniel Gray James Individual Corporate DirectorBoard Vice Chair Jan 1, 2023
Tracey Richardson Carroll Individual Corporate DirectorBoard Member Jan 1, 2026
Philip W. Young Individual Corporate DirectorBoard Member Jan 1, 2024
Brooke Regan Williams Individual Corporate DirectorExofficio Jan 1, 2019
Michelle Essick Younts Individual Corporate DirectorBoard Member Jan 21, 2026
Kenneth S Hall Individual Corporate DirectorBoard Chair Jan 1, 2025
Jan Briggs Individual Corporate DirectorBoard Member Jan 1, 2025
Lana J Riemann Individual W-2 Managing Employee Jan 14, 2019 40%
Gina Miller Idol Individual Corporate DirectorBoard Member Jan 1, 2026
Dale James Moorefield Individual Corporate DirectorBoard Vice Chair Mar 15, 2022
Catherine Elizabeth Michael Individual Corporate DirectorBoard Member Jan 1, 2023
Karen Hege Watford Individual Corporate DirectorBoard Member Jan 1, 2022
Edwina McPhatter Hardee Individual Corporate DirectorBoard Vice Chair Jan 1, 2023
Laura T. Owen Individual Corporate OfficerCeo Jun 27, 2011 100%
W-2 Managing EmployeeCeo Jun 27, 2011 60%

National Provider Directory

National Provider Directory
Tax ID family
Alderwood Medical Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 Hospice Way
Lexington, NC 27292
Phone (336) 474-2062

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Mr. Glen B Hubbard, CPA
Title
Chief Financial Officer
Phone
(336) 475-5444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOS0372 NC Primary

Addresses

Primary practice location

200 Hospice Way
Lexington, NC 27292-6989

Mailing address

200 Hospice Way
Lexington, NC 27292-6989
Phone (336) 475-5444

Other identifiers 1

IdentifierTypeStateIssuer
3401553MedicaidNC

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1568415271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPICE WAY",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926989",
            "telephone_number": "336-475-5444",
            "fax_number": "336-474-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPICE WAY",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272926989",
            "telephone_number": "336-475-5444",
            "fax_number": "336-474-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF DAVIDSON COUNTY NORTH CAROLINA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "HUBBARD",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "336-475-5444",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS0372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401553",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, NC

Sources for this page

Verify at the official NPI Registry.