Omega Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

108 Issued in MS

Legal business name

OMEGA HOSPICE, LLC

Practice address

970 Swinnea RDG
Suite 202
Southaven, MS 38671-6037

Phone

(662) 536-3191

Fax

(662) 536-3196

NPI assigned

Aug 2, 2006

Organization subpart

No

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

Authorized official

Name

Ramona Kaye Matthews

Title

Ceo/Administrator

Phone

(662) 536-3191

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1568479699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 SWINNEA RDG",
            "address_2": "SUITE 202",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716037",
            "telephone_number": "662-536-3191",
            "fax_number": "662-536-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 SWINNEA RDG",
            "address_2": "SUITE 202",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386716037",
            "telephone_number": "662-536-3191",
            "fax_number": "662-536-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "662-536-3191"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": "108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05257792",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.