Optum Palliative and Hospice Care, Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

0011-0296-H Issued in GA

Legal business name

OPTUM PALLIATIVE AND HOSPICE CARE, INC

Practice address

4875 Riverside Dr Ste 104
Macon, GA 31210-1149

Phone

(478) 812-9299

Fax

(478) 912-9270

NPI assigned

Mar 15, 2007

Organization subpart

Yes

Parent organization

COLLABORATIVE CARE HOLDINGS, LLCAs reported in NPPES

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

Authorized official

Name

John O. Enderle

Title

President/Ceo

Phone

(860) 221-0793

Specialties & licenses 2

Addresses

Other names 1

• Evercare Hospice, Inc. Former legal business name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Compassus Op of Georgia II LLC

  • Community Based Hospice Care Agency
  • Macon, GA
  • NPI 1376093534

  Sold to, 2017-01-01

  CMS change of ownership

Practitioners 1

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

• Aleshia Lewis Watson, M.D.

  • Internal Medicine Physician
  • Macon, GA
  • NPI 1275797649
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1609900364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "215-902-8241",
            "fax_number": "215-902-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 RIVERSIDE DR STE 104",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312101149",
            "telephone_number": "478-812-9299",
            "fax_number": "478-912-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM PALLIATIVE AND HOSPICE CARE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLABORATIVE CARE HOLDINGS, LLC",
        "enumeration_date": "2007-03-15",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "ENDERLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "860-221-0793"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "0011-0296-H",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evercare Hospice, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Stephen Kwaku Opoku, M.D.
• Opti-Pearl Vision Center, LLC
• Optim Orthopedics LLC
• Optimus Diagnostics LLC
• Optimus Ultrasound LLC
• Orange Blossom Health Care
• Afolabi Aliy Orekoya, MD
• Siobhan Oriaifo
• Joanna M Ortega, MD
• Louise Charlotte Orth, MD

• All providers in Macon, GA
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.