NPIMap

Organization Active NPI

Still Waters Hospice, LLC

  • Community Based Hospice Care Agency
  • Alexandria, LA
National Provider Identifier
1679642425
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
STILL WATERS HOSPICE, LLC
Practice address
1405 Metro Dr Ste L
Alexandria, LA 71301-3452
Phone
(318) 767-2000
Fax
(318) 442-5766
NPI assigned
Nov 7, 2006
Last updated
Nov 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Authorized official

Name
Mr. William Wayne Zito II
Title
Owner
Phone
(318) 767-2000

Specialties & licenses 1

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

Addresses

Primary practice location

1405 Metro Dr Ste L
Alexandria, LA 71301-3452

Mailing address

6932 Monroe Hwy
Ball, LA 71405-3232
Phone (318) 767-2000

Other identifiers 1

IdentifierTypeStateIssuer
1001821MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070126000229 LA Part A Provider - Hospice 3779584297 Practice locations: Alexandria, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679642425. Details of each certification follow.

Hospice certification: CCN 191636

Legal name
STILL WATERS HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 30, 2007
Last certification
Apr 15, 2021
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Incorporated
in LA
Enrollment address
1405 Metro Dr
Ste L
Alexandria, LA 71301-3452

Care Compare: Hospice

Medicare Care Compare
Listed as
Still Waters Hospice, LLCCCN 191636 · All quality measures
Ownership
For-Profit
Certified
Mar 30, 2007
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

6932 Monroe Hwy
Ball, LA 71405

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Sara B Zito Individual Limited Partnership InterestOwner Oct 1, 2006 50%
W-2 Managing EmployeeOwner Oct 1, 2006 50%
Still Waters Hospice, LLC Organization, Alexandria, LA LLC 5% Or Greater Direct Ownership Interest Oct 1, 2006 100%
William Zito Individual 5% Or Greater Direct Ownership Interest Nov 1, 2006 50%
Limited Partnership InterestOwner Nov 1, 2006 50%
Corporate Director Nov 22, 2006
W-2 Managing EmployeeOwner Nov 1, 2006 50%

Owners & managing parties with NPI records 1

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

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 1

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": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667520000000",
    "number": "1679642425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6932 MONROE HWY",
            "city": "BALL",
            "state": "LA",
            "postal_code": "714053232",
            "telephone_number": "318-767-2000",
            "fax_number": "318-442-5766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 METRO DR STE L",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013452",
            "telephone_number": "318-767-2000",
            "fax_number": "318-442-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A",
        "authorized_official_last_name": "ZITO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-767-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001821",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.