NPIMap

Organization Active NPI

Hospice & Palliative Carecenter

Doing business as Trellis Supportive Care

  • Community Based Hospice Care Agency
  • Winston Salem, NC
National Provider Identifier
1659300770
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HC0409 Issued in NC
Legal business name
HOSPICE & PALLIATIVE CARECENTER
Doing business as
Trellis Supportive Care
Practice address
101 Hospice LN
Winston Salem, NC 27103-5766
Phone
(336) 768-3972
Fax
(336) 659-0461
NPI assigned
Jul 1, 2006
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
David Shelton
Title
Cfo
Phone
(336) 331-1260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HC0409 NC Primary

Addresses

Primary practice location

101 Hospice LN
Winston Salem, NC 27103-5766

Mailing address

101 Hospice LN
Winston Salem, NC 27103-5766
Phone (336) 768-3972

Other identifiers 7

IdentifierTypeStateIssuer
0023AOtherNCBCBS HOSPICE
28048OtherNCPARTNERS HOMEHEALTH
3401502MedicaidNC
6600079MedicaidNC
3407106MedicaidNC
00735OtherNCBCBS HOMEHEALTH
41731OtherNCPARTNERS HOSPICE

Other names 1

  • Trellis Supportive Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070424000527 NC Part B Supplier - Clinic/Group Practice 4688604408 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winston Salem, NC
O20140515001360 NC Part A Provider - Hospice 4688604408 Practice locations: Mocksville, NC; Salisbury, NC; Walnut Cove, NC; Winston Salem, NC

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1659300770. Details of each certification follow.

Hospice certification: CCN 341502

Legal name
HOSPICE & PALLIATIVE CARECENTER
Doing business as
TRELLIS SUPPORTIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 10, 1985
Last certification
Jan 26, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Jul 19, 1978 in NC
Enrollment address
101 Hospice Lane
Winston Salem, NC 27103-5766

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Trellis Supportive CareCCN 341502 · All quality measures
Ownership
Non-Profit
Certified
Jan 10, 1985
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

377 Hospital St
Ste 103
Mocksville, NC 27028
Phone (336) 753-0212

810 S Main St
Ste 105
Walnut Cove, NC 27052
Phone (336) 591-1124

101 Hospice Ln
Winston Salem, NC 27103
Phone (336) 768-3972

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Michael J Lalor Individual Corporate OfficerPresident & Ceo Jun 15, 2025
Jennifer L Bauguss Individual W-2 Managing EmployeeVP Compliance & Quality Feb 12, 2018
Mike Gwyn Individual Corporate DirectorBoard Member - Chair Jan 1, 2024
Timothy Mark Corbett Individual W-2 Managing EmployeeMD; Oct 1, 2023
Teresa Lindsay Individual Corporate DirectorBoard Member - Vice Chair Jan 1, 2024
Della Wildfong Individual Corporate DirectorBoard Member - Treasurer Jan 1, 2024
Timothy Sechrest Individual Corporate DirectorBoard Member Jul 18, 2014
David Shelton Individual W-2 Managing EmployeeChief Financial Officer Dec 29, 2014

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

Affiliated clinicians 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1659300770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPICE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035766",
            "telephone_number": "336-768-3972",
            "fax_number": "336-659-0461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPICE LN",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035766",
            "telephone_number": "336-768-3972",
            "fax_number": "336-659-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE & PALLIATIVE CARECENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "336-331-1260"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HC0409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOSPICE",
            "identifier": "0023A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS HOMEHEALTH",
            "identifier": "28048",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401502",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6600079",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3407106",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOMEHEALTH",
            "identifier": "00735",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS HOSPICE",
            "identifier": "41731",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trellis Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.