NPIMap

Organization Active NPI

Hospice & Palliative Carecenter

Doing business as Trellis Supportive Care

  • Internal Medicine Physician
  • Winston Salem, NC
National Provider Identifier
1730367467
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HOSPICE & PALLIATIVE CARECENTER
Doing business as
Trellis Supportive Care
Practice address
101 Hospice LN
BLDG 141
Winston Salem, NC 27103-5766
Phone
(336) 768-3972
Fax
(336) 659-0461
NPI assigned
Feb 5, 2008
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
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

101 Hospice LN
BLDG 141
Winston Salem, NC 27103-5766

Mailing address

101 Hospice Lane BLDG 141
Hospice and Palliative Care Center
Winston Salem, NC 27103-5766
Phone (336) 768-3972

Other identifiers 3

IdentifierTypeStateIssuer
00735OtherNCBCBS HOMEHEALTH
15115OtherNCMEDCOST
0023AOtherNCBCBS HOSPICE

Other names 1

  • Trellis Supportive Care Doing business as

Medicare participation

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

Enrollment records 1

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
Practice locations: Winston Salem, NC

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.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

101 Hospice Ln
Bldg 141
Winston Salem, NC 27103
Phone (336) 768-3972

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1730367467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPICE LANE BLDG 141",
            "address_2": "HOSPICE AND PALLIATIVE CARE CENTER",
            "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",
            "address_2": "BLDG 141",
            "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": "2008-02-05",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOMEHEALTH",
            "identifier": "00735",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "15115",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS HOSPICE",
            "identifier": "0023A",
            "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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.