Comfort Care Hospice, LLC
Organization Active NPI Community Based Hospice Care Agency · Andalusia, AL
NPI 1649235706 · NPPES record last updated Jan 27, 2025
Key facts
- NPI
- 1649235706
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 10206 (AL)
- Legal business name
- COMFORT CARE HOSPICE, LLC
- Practice address
- 820 S Three Notch St Ste C
Andalusia, AL 36420-5360 - Phone
- (334) 427-4000
- Fax
- (334) 427-4004
- NPI assigned
- Apr 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Matthew Buckhalter
- Title
- Cfo
- Phone
- (470) 464-8000
Owners & managing parties with NPI records 1
-
Joanne Holliday Smith, D.O.
Owned or controlled facilities with NPI records 2
Other NPIs with the same Medicare PAC ID 9
Corporate family (same tax ID) 9
Facilities with the same owner 122
Affiliated clinicians 8
-
Rex Allen Butler, M.D.
-
Charles Reid Kerr, M.D.
-
James R Norman, MD
-
Joanne Holliday Smith, D.O.
-
Sasikumar Vishwanath, M.D.
-
David E Mann Jr., MD
Medicare Care Compare: Hospice
- Listed as
- Aveanna Hospice of Andalusia
- Ownership
- For-Profit
- Certified
- May 14, 2003
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Hospice certification: CCN 011597
- Legal name
- COMFORT CARE HOSPICE LLC
- Doing business as
- AVEANNA HOSPICE OF ANDALUSIA
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- May 14, 2003
- Last certification
- Nov 4, 2021
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 29, 1999 in AL
- Enrollment address
- 820 S Three Notch St
Ste C
Andalusia, AL 36420-5360
All disclosed owners & managing parties 18
| Name | Role | Since | Share |
|---|---|---|---|
| J.H. Whitney VII LP |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 16.36% |
| Psa Healthcare Investment Holding LLC |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 8.17% |
| Aveanna Healthcare LLC |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 100% |
| Aveanna Healthcare Intermediate Holdings LLC |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 100% |
| Kimberly Ray |
W-2 Managing Employee |
Feb 6, 2022 | |
| Aveanna Healthcare Holdings Inc |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 100% |
| Nut Tree Master Fund LP |
5% Or Greater Indirect Ownership Interest | Dec 31, 2023 | 6.43% |
| Matthew Buckhalter |
Corporate Officer |
Jul 7, 2023 | |
| Corporate Director |
Jul 7, 2023 | ||
| Bcip Associates IV US L.P. |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 5.43% |
| Hamilton Lane Co-Investment Fund III Holdings - 2 LP |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 7.62% |
| Deborah Stewart |
Corporate Director |
Jul 7, 2023 | |
| Bain Capital Fund XI LP |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 36.04% |
| Jerrold Perchik |
Corporate Officer |
Apr 29, 2024 | |
| Aveanna Healthcare Senior Services LLC |
5% Or Greater Direct Ownership Interest | Dec 10, 2021 | 100% |
| Bcpe Eagle Investor, L.P. |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 42.42% |
| Joanne Marie Smith |
W-2 Managing Employee |
Jul 1, 2023 | |
| Jeffrey Shaner |
Corporate Officer |
Dec 10, 2021 | |
| Corporate Director |
Jan 1, 2023 | ||
| Pea Washington Holdings, LP |
5% Or Greater Indirect Ownership Interest | Dec 10, 2021 | 5.54% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Aveanna Hospice of Fairhope |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Nov 17, 2015 |
| Aveanna Hospice |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Apr 15, 2019 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051219000333 | AL | Part a Provider - Hospice | 9133038243 | Practice locations: Andalusia, AL |
National Provider Directory
- Tax ID family
- Comfort Care Hospice LLC
Locations
820 S Three Notch St
Ste C
Andalusia, AL 36420
Phone (334) 427-4000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 10206 | AL | Yes |
Addresses
Primary practice location
820 S Three Notch St Ste C
Andalusia, AL 36420-5360
Mailing address
400 Interstate North Pkwy SE Ste 1600
Atlanta, GA 30339-5047
Phone (470) 464-8000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PIC1597E | Medicaid | AL |
Other names
- Aveanna Hospice of Andalusia
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All providers in Andalusia, AL · Community Based Hospice Care Agency in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.