Affinis Hospice, LLC
Organization Active NPI Community Based Hospice Care Agency · Waycross, GA
NPI 1740656180 · NPPES record last updated Nov 3, 2023
Key facts
- NPI
- 1740656180
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- AFFINIS HOSPICE, LLC
- Practice address
- 1705 Boulevard SQ Ste C
Waycross, GA 31501-8032 - Phone
- (912) 590-0121
- Fax
- (912) 590-0132
- NPI assigned
- Aug 20, 2015
- Organization subpart
- No
Authorized official
- Name
- Sarah A Thompson, RN, CHPN
- Title
- Vice President of Operations
- Phone
- (478) 319-4921
Owners & managing parties with NPI records 1
Other NPIs with the same Medicare PAC ID 10
Corporate family (same tax ID) 10
Member of 1
Facilities with the same owner 11
Affiliated clinicians 4
-
William Alan Morton, M.D.
-
James Stanley Sinclair, M.D.
Medicare Care Compare: Hospice
- Listed as
- Affinis Hospice
- Ownership
- Non-Profit
- Certified
- Jun 29, 2016
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2123211 | Affinis Hospice, LLC | Certificate of waiver | Dec 14, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Hospice certification: CCN 111781
- Legal name
- AFFINIS HOSPICE, LLC
- Doing business as
- AFFINIS HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jun 29, 2016
- Last certification
- Apr 18, 2019
- Ownership / control type
- Non-Profit - Private
- Organization structure
- LLC · Non-profit
- Incorporated
- in GA
- Enrollment address
- 1705 Boulevard SQ
Ste C
Waycross, GA 31501-8032
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Home and Community Services Inc |
5% Or Greater Direct Ownership Interest | Jan 1, 2021 | 100% |
| Michael D Satchell |
Operational/Managerial Control |
Jul 1, 2025 | 100% |
| Melissa Murray |
Corporate Officer |
Sep 27, 2024 | 100% |
| W-2 Managing Employee |
Sep 27, 2024 | 100% | |
| Sarah a Thompson |
Corporate Director | Feb 14, 2010 | 100% |
| W-2 Managing Employee |
Feb 14, 2010 | 100% | |
| Operational/Managerial Control |
Feb 14, 2010 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151016002375 | GA | Part a Provider - Hospice | 1759579253 | Practice locations: Waycross, GA |
National Provider Directory
- Tax ID family
- Affinis Hospice
Locations
1705 Boulevard Sq
Ste C
Waycross, GA 31501
Phone (912) 283-3066
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
1705 Boulevard SQ Ste C
Waycross, GA 31501-8032
Mailing address
806 Maple Dr
Vidalia, GA 30474-7208
Phone (912) 538-0465
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003181261A | Medicaid | GA |
Other names
- Affinis Hospice
Other providers in Waycross, GA
- Access Dermpath, Inc.
- Peggy Achenbach
- David William Acker
- Jamie Lynn Adams
- Stephen Randall Adcock
- Stanley A Agbulos
- Air Evac EMS, Inc.
- Oladotun Akintomide
- John W Akridge Jr.
- Andrea Janan Albritton
All providers in Waycross, GA · Community Based Hospice Care Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.