NPIMap

Organization Active NPI

LHCG Xxix LLC

Doing business as Alabama Hospice of the Shoals

  • Community Based Hospice Care Agency
  • Tuscumbia, AL
National Provider Identifier
1629376918
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LHCG XXIX LLC
Doing business as
Alabama Hospice of the Shoals
Practice address
1404 E Avalon Ave
Suite C
Tuscumbia, AL 35674-1773
Phone
(256) 314-1204
Fax
(256) 314-1206
NPI assigned
Mar 10, 2011
Last updated
Nov 24, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Authorized official

Name
Mr. Nicholas Gachassin III
Title
Secretary / Treasurer
Phone
(337) 233-1307

Specialties & licenses 1

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

Addresses

Primary practice location

1404 E Avalon Ave
Suite C
Tuscumbia, AL 35674-1773

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other identifiers 1

IdentifierTypeStateIssuer
129891MedicaidAL

Other names 1

  • Alabama Hospice of the Shoals Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110503000566 AL Part A Provider - Hospice 6002090438 Practice locations: Tuscumbia, AL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629376918. Details of each certification follow.

Hospice certification: CCN 011632

Legal name
LHCG XXIX, LLC
Doing business as
ALABAMA HOSPICE OF THE SHOALS
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 20, 2005
Last certification
Feb 24, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
1404 E Avalon Ave
Ste C
Tuscumbia, AL 35674-1771

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Alabama Hospice of the ShoalsCCN 011632 · All quality measures
Ownership
For-Profit
Certified
Oct 20, 2005
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D1038013LHCG Xxix Dba Alabama Hospice of the Shoals1404 East Avalon Avenue Suite C, Tuscumbia, AL 35674Certificate of waiverMar 8, 2027

National Provider Directory

National Provider Directory
Tax ID family
Alabama Hospice of the Shoals2 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.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1404 E Avalon Ave
Ste C
Tuscumbia, AL 35674
Phone (256) 314-1204

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Michelle Adams Individual W-2 Managing EmployeeAdministrator/Director of Nursing Feb 1, 2021
Operational/Managerial ControlAdministrator/Director of Nursing Feb 1, 2021
Unitedhealth Group Incorporated Organization, Minnetonka, MN Corporation 5% Or Greater Indirect Ownership Interest Feb 22, 2023 67%
Kimberly Seymour Individual Corporate OfficerCoo Apr 13, 2026
W-2 Managing EmployeeCoo Apr 13, 2026
Joni Babineaux Individual Corporate OfficerCfo Apr 13, 2026
LHC Group Inc Organization, Lafayette, LA Corporation 5% Or Greater Indirect Ownership Interest Apr 5, 2011
Operational/Managerial Control Mar 24, 2011
Joshua Lee Proffitt Individual Corporate OfficerPresident Dec 31, 2019
Aaron Waite Karr Individual Contracted Managing EmployeeMD; Jan 1, 2026
Colbert County NW Alabama Healthcare Authority Organization, Sheffield, AL Corporation 5% Or Greater Direct Ownership Interest Apr 5, 2011 33%
Alabama Health Care Group, LLC Organization, Lafayette, LA LLC 5% Or Greater Direct Ownership Interest Apr 5, 2011 67%
Amy Cormier Individual Corporate Director May 1, 2025

Owners & managing parties with NPI records 3

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

Facilities with the same owner 18

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

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 2

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

NPI Registry JSON

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606176000000",
    "number": "1629376918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-233-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 E AVALON AVE",
            "address_2": "SUITE C",
            "city": "TUSCUMBIA",
            "state": "AL",
            "postal_code": "356741773",
            "telephone_number": "256-314-1204",
            "fax_number": "256-314-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHCG XXIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-10",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "GACHASSIN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "SECRETARY / TREASURER",
        "authorized_official_telephone_number": "337-233-1307",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "129891",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alabama Hospice of the Shoals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tuscumbia, AL

Sources for this page

Verify at the official NPI Registry.