NPIMap

Organization Active NPI

West Georgia Medical Center, Inc.

Doing business as West Georgia Hospice

  • Inpatient Hospice
  • Lagrange, GA
National Provider Identifier
1649403973
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
Legal business name
WEST GEORGIA MEDICAL CENTER, INC.
Doing business as
West Georgia Hospice
Practice address
1510 Vernon Rd
Lagrange, GA 30240-4131
Phone
(706) 845-3905
Fax
(706) 845-8918
NPI assigned
Sep 3, 2009
Last updated
Feb 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Mr. John G Kerndl
Title
Evp
Phone
(470) 644-0076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X NU Primary

Addresses

Primary practice location

1510 Vernon Rd
Lagrange, GA 30240-4131

Mailing address

1800 Parkway PL SE Ste 500
Marietta, GA 30067-8237
Phone (470) 956-4981

Other identifiers 1

IdentifierTypeStateIssuer
00371896AMedicaidGA

Other names 1

  • West Georgia Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091113000510 GA Part A Provider - Hospice 9335286160 Practice locations: Lagrange, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649403973. Details of each certification follow.

Hospice certification: CCN 111516

Legal name
WEST GEORGIA MEDICAL CENTER, INC
Doing business as
WEST GEORGIA HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 19, 1987
Last certification
Nov 10, 2020
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Aug 4, 2006 in GA
Enrollment address
1510 Vernon Rd
Lagrange, GA 30240-4131

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
West Georgia HospiceCCN 111516 · All quality measures
Ownership
Non-Profit
Certified
Feb 19, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
West Ga Medical Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 22

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

NameRoleSinceShare
William C Brock Individual Corporate DirectorBoard Member Apr 1, 2016 5%
Heather Graham Individual Corporate DirectorBoard Member Sep 1, 2025 5%
Joseph a Reppert Individual Corporate OfficerSenior Vice President of Finance Apr 4, 2024 100%
W-2 Managing EmployeeSenior Vice President of Finance Aug 3, 2020 100%
Orrin S Swayze Individual Corporate DirectorBoard Member Apr 1, 2016 5%
John C McKibben Individual Corporate Officer Nov 21, 2011
Corporate Director Oct 1, 2009
Keith Parker Individual Corporate DirectorBoard Member Jul 1, 2023 5%
Paul Lawrence Douglass Individual Corporate DirectorBoard Member Aug 22, 2016 5%
Mitzi Moore Individual Corporate DirectorBoard Member Apr 1, 2016 5%
Wellstar Health System Inc Organization, Marietta, GA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2016 100%
Gretchen Corbin Individual Corporate DirectorBoard Member Oct 3, 2024 5%
John Kerndl Individual Corporate OfficerEvp & Cfo Feb 17, 2025 100%
W-2 Managing EmployeeEvp & Cfo Feb 17, 2025 100%
James Glen Cunningham Individual Corporate DirectorBoard Member Mar 4, 2021 5%
Ebenezer Erzuah Individual W-2 Managing Employee Apr 1, 2016
Mark Berry Individual Corporate DirectorBoard Member Oct 7, 2021 5%
James Holmes Individual Corporate DirectorBoard Member Apr 4, 2019 5%
Ketul J Patel Individual Corporate OfficerPresident & Ceo Oct 30, 2025 100%
W-2 Managing EmployeePresident & Ceo Oct 30, 2025 100%
Greg Morgan Individual Corporate DirectorBoard Member Apr 1, 2016 5%
James L Hornsby Individual Corporate DirectorBoard Member Jul 1, 2018 5%
Edward Richardson Individual Corporate DirectorBoard Member Apr 4, 2019 5%
David Bottoms Individual Corporate DirectorBoard Member Feb 2, 2023 5%
Frank Ros Individual Corporate DirectorBoard Member Apr 1, 2016 5%
West Georgia Medical Center, Inc Organization, Lagrange, GA 5% Or Greater Direct Ownership Interest Oct 1, 2009

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
West Georgia Home CareLagrange, GA, CCN 117032 Home health agency 5% Or Greater Direct Ownership Interest Oct 1, 2009

Owned or controlled facilities with NPI records 1

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

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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": "1251936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1649403973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PARKWAY PL SE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678237",
            "telephone_number": "470-956-4981",
            "fax_number": "770-999-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-845-3905",
            "fax_number": "706-845-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-03",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "KERNDL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0076",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00371896A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Georgia Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "West Georgia Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.