NPIMap

Organization Active NPI

St. Joseph Hospice and Palliative Care Northshore LLC

  • Community Based Hospice Care Agency
  • Covington, LA
National Provider Identifier
1710051669
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
202 Issued in LA
Legal business name
ST. JOSEPH HOSPICE AND PALLIATIVE CARE NORTHSHORE LLC
Practice address
409 W 21St Ave
Covington, LA 70433-3011
Phone
(985) 892-6955
Fax
(985) 302-3754
NPI assigned
Nov 20, 2006
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Patrick Mitchell
Title
Managing Member
Phone
(225) 769-2449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 202 LA Primary

Addresses

Primary practice location

409 W 21St Ave
Covington, LA 70433-3011

Mailing address

10615 Jefferson Hwy
Baton Rouge, LA 70809-7230
Phone (225) 769-2449

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070126000280 LA Part A Provider - Hospice 9739180258 Practice locations: Covington, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710051669. Details of each certification follow.

Hospice certification: CCN 191635

Legal name
ST. JOSEPH HOSPICE AND PALLIATIVE CARE NORTHSHORE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 19, 2007
Last certification
Oct 5, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
409 W 21St Ave
Ste a
Covington, LA 70433-3011

Care Compare: Hospice

Medicare Care Compare
Listed as
St Joseph Hospice and Palliative Care Northshore,CCN 191635 · All quality measures
Ownership
For-Profit
Certified
Mar 19, 2007
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
19D1064405St Joseph Hospice and Palliative Care-Northshore409 W 21St Avenue, Covington, LA 70433Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Locations

1121 S Tyler St
Unit 5
Covington, LA 70433
Phone (985) 626-9980

409 W 21st Ave
Ste A
Covington, LA 70433
Phone (985) 892-6955

1400 Gause Blvd
Slidell, LA 70458

1400 Gause Blvd
Ste 200
Slidell, LA 70458
Phone (985) 257-4090

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Shahed M Jameel Individual Contracted Managing EmployeeHospice Medical Director Feb 17, 2021
Melissa Lynn Taylor Individual W-2 Managing EmployeeAd; Mar 10, 2026
Patrick Thomas Mitchell Individual Operational/Managerial ControlManager Oct 19, 2006
Other May 1, 2019 1%
PCM Hospice Enterprises LLC Organization, Baton Rouge, LA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest May 1, 2019 100%
Kelly Mitchell Individual OtherCo-Managing Trustee Dec 31, 2022
PCM Intermediate Holdings LLC Organization, Baton Rouge, LA LLC, Holding company 5% Or Greater Indirect Ownership Interest Jul 18, 2025 100%
PTM 2018 Family Trust Organization, Baton Rouge, LA Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2022 99%
Emily Holleman Individual OtherCo-Managing Trustee Dec 31, 2022
PCM Holdings I, Inc. Organization, Baton Rouge, LA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Jul 18, 2025 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 35

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

View all 35

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1710051669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708097230",
            "telephone_number": "225-769-2449",
            "fax_number": "225-757-1104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W 21ST AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704333011",
            "telephone_number": "985-892-6955",
            "fax_number": "985-302-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH HOSPICE AND PALLIATIVE CARE NORTHSHORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "225-769-2449"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.