Courtland Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

COURTLAND HOSPICE INC

Practice address

3065 Peachtree Industrial Blvd Ste 100a
Duluth, GA 30097-8608

Phone

(773) 719-5566

NPI assigned

Mar 3, 2022

Organization subpart

No

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

Authorized official

Name

Oghenerume Siebere

Title

Owner

Phone

(773) 719-5566

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 851579

Legal name

COURTLAND HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 13, 2023

Last certification

Jul 13, 2023

Organization structure

CorporationProprietary

Incorporated

Feb 14, 2022 in GA

Enrollment address

3065 Peachtree Industrial Blvd
Ste 100C
Duluth, GA 30097-8608

Listed as

Courtland Hospice IncCCN 851579

Certified

Jul 13, 2023

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 2

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

Practitioners 1

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

• Chinedu Anaje, RN

  • Home Health Registered Nurse
  • Duluth, GA
  • NPI 1598624900
  NPD (past)

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1598412124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 PEACHTREE INDUSTRIAL BLVD STE 100A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978608",
            "telephone_number": "773-719-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 PEACHTREE INDUSTRIAL BLVD STE 100A",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300978608",
            "telephone_number": "773-719-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COURTLAND HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "SIEBERE",
        "authorized_official_first_name": "OGHENERUME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-719-5566"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie W Couch, MS,BCBA
• Bakaramoko Coulibaly, RPH
• Counseling Center at Duluth LLC
• Elizabeth Anne Coursey, CPNP-PC
• Courtland Health Care Services
• Michelle Angie Covalt, MD
• Karyanna K Cox
• Nigeria Kysmyu Cox
• William H. Cox, D.O.
• Ayannah Tiombe Craig

• Community Based Hospice Care Agency in Duluth, GA
• Providers in Duluth, 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 Mar 3, 2022; 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.