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Organization Active NPI

Health Care Authority for Baptist Health, an Affiliate of Uabhs

  • Community Based Hospice Care Agency
  • Montgomery, AL
National Provider Identifier
1578657367
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
11723 Issued in AL
Legal business name
HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS
Practice address
301 Interstate Park Dr
Montgomery, AL 36109-5408
Phone
(334) 395-5000
NPI assigned
Oct 3, 2006
Organization subpart
Yes
Parent organization
HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Authorized official

Name
Ms. Katrina Keefer Belt
Title
Chief Financial Officer
Phone
(334) 273-4447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 11723 AL Primary

Addresses

Primary practice location

301 Interstate Park Dr
Montgomery, AL 36109-5408

Mailing address

301 Interstate Park Dr
Montgomery, AL 36109-5408
Phone (334) 395-5000

Other identifiers 2

IdentifierTypeStateIssuer
010-367OtherALBLUE CROSS BLUE SHIELD
PIC1500EMedicaidAL

Other names 1

  • Baptist Medical Center South- Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051105000225 AL Part A Provider - Hospice 8426076670 Practice locations: Montgomery, AL

Hospice certification: CCN 011500

Legal name
HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS
Doing business as
BAPTIST HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 23, 1984
Last certification
Mar 15, 2018
Ownership / control type
Other
Organization structure
OtherProprietary
Incorporated
Jul 1, 2005 in AL
Enrollment address
2001 E South Blvd
Ste 101
Montgomery, AL 36116-2463

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Surgery Specialists19 organizations share this tax ID, including this one
Part of
Montgomery Surgery Specialists

Other organizations with this tax ID 18

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

View all 18

Locations

301 Interstate Park Dr
Montgomery, AL 36109
Phone (334) 395-5000

2001 E South Blvd
Ste 101
Montgomery, AL 36116
Phone (334) 747-5000

Ownership & related parties

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.

NameRoleSinceShare
Walter Tyner Individual Corporate OfficerCeo Jun 1, 2021
Christine E Bruton Individual Corporate OfficerCfo Jun 1, 2021
Robert a Avery Individual Contracted Managing EmployeeMedical Director Mar 5, 2024
Health Care Authority for Baptist Health, an Affiliate of Uabhs Organization, Montgomery, AL Corporation 5% Or Greater Direct Ownership Interest Jul 1, 2005 100%
John Selman Individual Corporate OfficerCeo Jul 1, 2013
W-2 Managing EmployeeCeo Jul 1, 2013

Owners & managing parties with NPI records 9

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

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Baptist Medical Center SouthMontgomery, AL, CCN 010023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2005
Prattville Baptist HospitalPrattville, AL, CCN 010108 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2005
Baptist Medical Center EastMontgomery, AL, CCN 010149 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2005
Baptist Medical Center South, Dba CrossbridgeMontgomery, AL, CCN 01S023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 2005
Prattville Baptist Hospital Geriatric Behavioral HealthPrattville, AL, CCN 01S108 Hospital 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2021

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 272

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

View all 272

Affiliated clinicians 8

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Baptist HospiceCCN 011500
Ownership
Other
Certified
Mar 23, 1984
Medicare certification status
ActiveFrom the Provider of Services file

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277942400000",
    "number": "1578657367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 INTERSTATE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361095408",
            "telephone_number": "334-395-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INTERSTATE PARK DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361095408",
            "telephone_number": "334-395-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH CARE AUTHORITY FOR BAPTIST HEALTH, AN AFFILIATE OF UABHS",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-07-01",
        "status": "A",
        "authorized_official_last_name": "BELT",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "KEEFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "334-273-4447",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AL",
            "license": "11723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "010-367",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PIC1500E",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Center South- Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.