NPIMap

Organization Active NPI

Southerncare, Inc.

  • Community Based Hospice Care Agency
  • Bossier City, LA
National Provider Identifier
1740229178
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
257 Issued in LA
Legal business name
SOUTHERNCARE, INC.
Practice address
590 Boardwalk Blvd
Suite Bo-590
Bossier City, LA 71111-4384
Phone
(318) 227-9160
Fax
(318) 227-9781
NPI assigned
Jun 4, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Janet Combs
Title
VP of Licensure
Phone
(704) 662-1761

Owners & managing parties with NPI records 19

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

Corporate family (same tax ID) 42

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

View all 42

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Facilities with the same owner 195

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

View all 195

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 4

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

Care Compare: Hospice

Medicare Care Compare
Listed as
GentivaCCN 191580
Ownership
For-Profit
Certified
Aug 28, 2003
Medicare certification status
Active (Provider of Services file)

Medicare participation

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

Hospice certification: CCN 191580

Medicare enrollment files
Legal name
SOUTHERNCARE, INC.
Doing business as
GENTIVA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 28, 2003
Last certification
Jun 3, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Dec 31, 2002 in DE
Enrollment address
590 Boardwalk Blvd
Ste Bo-590
Bossier City, LA 71111-4384

All disclosed owners & managing parties 24

Medicare enrollment files

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

NameRoleSinceShare
CH Services Midco Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
Kentucky Homecare Parent Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Ronald C Lazas Individual Corporate OfficerExecutive VP and General Counsel Apr 27, 2021
Corporate DirectorBoard Member Dec 31, 2021
Curo Health Services Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
David Robinson Arnold Individual Corporate OfficerVP, Treasurer Dec 31, 2021
OtherVP and Treasurer Dec 31, 2021
Curo Hospice SC LLC Organization, Mooresville, NC LLC, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Kimber Lumley Individual W-2 Managing EmployeeAd; Oct 31, 2025
Thomas Joseph Dolan Individual Corporate OfficerChief Financial Officer Nov 30, 2021
Ksoc Holdings, Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Southerncare Holdings, Inc. Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Direct Ownership Interest Jun 6, 2014 100%
Charlotte Midco, LLC Organization, Atlanta, GA LLC, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Kentucky Homecare Holdings, Inc. Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Humana Inc Organization, Louisville, KY Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Falcon Hospice, LP Organization, Atlanta, GA For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerChief Executive Officer / President Apr 27, 2021
Corporate DirectorBoard Member Dec 31, 2021
Charlotte Buyer, Inc. Organization, Fort Worth, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Jul 11, 2018 100%
Curo Health Services LLC Organization, Mooresville, NC LLC, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Jun 6, 2014 100%
Operational/Managerial Control Jun 6, 2014 100%
Janet L Combs Individual Corporate OfficerVP Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Centerwell Health Services Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 11, 2022 40%
Kah Hospice Company, Inc Organization, Atlanta, GA Corporation, For-profit 5% Or Greater Indirect Ownership Interest Mar 1, 2022 100%
Tom C Rodsuwan Individual Contracted Managing EmployeeMD; Jun 26, 2019
CH Services Group Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
CH Services Holdings Inc Organization, Mooresville, NC Corporation, For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%

All facility ownership & control disclosures 1

Medicare enrollment files

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

FacilityTypeRoleSince
Gentiva IICincinnati, OH, CCN 361704 Hospice 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2017

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20051005001120 LA Part a Provider - Hospice 8527977735 Practice locations: Bossier City, LA

National Provider Directory

National Provider Directory
Tax ID family
Southerncare Inc (43 organizations share this tax ID)

Locations

590 Boardwalk Blvd
#590
Bossier City, LA 71111

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 131 LA
Community Based Hospice Care Agency 251G00000X 257 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

590 Boardwalk Blvd
Suite Bo-590
Bossier City, LA 71111-4384

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 662-0416

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1580881MedicaidLA

Other names 1

NPPES NPI Registry
  • Gentiva Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 11, 2023.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673395200000",
    "number": "1740229178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4060",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281174060",
            "telephone_number": "704-662-0416",
            "fax_number": "704-664-1306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 BOARDWALK BLVD",
            "address_2": "SUITE BO-590",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711114384",
            "telephone_number": "318-227-9160",
            "fax_number": "318-227-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERNCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LICENSURE",
        "authorized_official_telephone_number": "704-662-1761",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "131",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1580881",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentiva",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bossier City, LA

Sources for this page

Verify at the official NPI Registry.