NPIMap

Organization Active NPI

Regency Hospice of Georgia, LLC

  • Community Based Hospice Care Agency
  • Augusta, GA
National Provider Identifier
1760440424
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
111637 Issued in GA
Legal business name
REGENCY HOSPICE OF GEORGIA, LLC
Practice address
2924 Professional Pkwy
Suite a
Augusta, GA 30907-6529
Phone
(706) 868-4422
Fax
(706) 868-4424
NPI assigned
May 3, 2006
Last updated
May 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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

Authorized official

Name
Janet Combs
Title
VP of Legal Affairs
Phone
(913) 814-2013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 111637 GA Primary

Addresses

Primary practice location

2924 Professional Pkwy
Suite a
Augusta, GA 30907-6529

Mailing address

PO Box 4060
Mooresville, NC 28117-4060
Phone (704) 644-2876

Other practice location 1

2311 E 1st St Ste B
Vidalia, GA 30474-8811
Phone (912) 537-2273

Other practice location 2

143 US Highway 319 S
Moultrie, GA 31768-7991
Phone (229) 217-0523

Other practice location 3

350 S Main St
Hiawassee, GA 30546-3472
Phone (706) 896-1251

Other practice location 4

5233 Riverside Dr Ste E
Macon, GA 31210-1253
Phone (478) 476-4627

Other practice location 5

4255 Wade Green Rd NW Ste 210
Kennesaw, GA 30144-1810
Phone (770) 529-8155

Other practice location 6

7 Allen Cail Dr Ste A&b
Statesboro, GA 30458-2100
Phone (912) 681-6838

Other identifiers 1

IdentifierTypeStateIssuer
000457509DMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060607000229 GA Part A Provider - Hospice 7810807013 Practice locations: Augusta, GA; Vidalia, GA; Statesboro, GA; Moultrie, GA; Kennesaw, GA; Hiawassee, GA; Macon, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1760440424. Details of each certification follow.

Hospice certification: CCN 111637

Legal name
REGENCY HOSPICE OF GEORGIA, LLC
Doing business as
REGENCY SOUTHERNCARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 7, 2006
Last certification
Mar 9, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Nov 9, 2011 in DE
Enrollment address
2924 Professional Pkwy
Augusta, GA 30907-6529

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Regency SoutherncareCCN 111637 · All quality measures
Ownership
For-Profit
Certified
Sep 7, 2006
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
11D2067822Regency Hospice of Georgia, LLC - Augusta2924 Professional Parkway, Augusta, GA 30907Certificate of waiverOct 22, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2924 Professional Pkwy
Ste A
Augusta, GA 30907
Phone (706) 868-4422

143 US Highway 319 S
Moultrie, GA 31768
Phone (229) 217-0523

7 Allen Cail Dr
Ste Ab
Statesboro, GA 30458
Phone (912) 681-6838

2311 E 1st St
#B
Vidalia, GA 30474
Phone (912) 537-2273

Ownership & related parties

All disclosed owners & managing parties 23

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 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
Curo Health Services Holdings, Inc Organization, Mooresville, NC For-profit 5% Or Greater Indirect Ownership Interest Nov 9, 2011
David Robinson Arnold Individual Corporate OfficerVP and Controller Dec 31, 2021
Operational/Managerial ControlHome Office Administrator Dec 31, 2021
Thomas Joseph Dolan Individual Corporate OfficerChief Financial Officer Nov 30, 2021
Charlotte Midco, LLC Organization, Atlanta, GA LLC 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 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
David Allen Causby Individual Corporate OfficerChief Executive Officer / President Apr 27, 2021
Regency Healthcare Holdings LLC Organization, Mooresville, NC For-profit 5% Or Greater Indirect Ownership Interest Apr 15, 2011 100%
Jonathan E Reimer Individual Contracted Managing EmployeeMD; Oct 31, 2011
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 5% Or Greater Indirect Ownership Interest Nov 9, 2011
Janet L Combs Individual Corporate OfficerVP Licensure Nov 1, 2021
CD&R Falcon Holdings, LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Aug 11, 2022 60%
Amber Cooper Individual W-2 Managing EmployeeAd; Feb 17, 2022
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 5% Or Greater Indirect Ownership Interest Aug 11, 2022 100%
Regency Healthcare Group LLC Organization, Mooresville, NC LLC, Non-profit 5% Or Greater Direct Ownership Interest May 15, 2006 100%
General Partnership Interest May 15, 2006
Operational/Managerial Control May 15, 2006
CH Services Group Holdings Inc Organization, Mooresville, NC For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%
CH Services Holdings Inc Organization, Mooresville, NC For-profit 5% Or Greater Indirect Ownership Interest Feb 5, 2015 100%

Owners & managing parties with NPI records 19

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

View all 19

Facilities with the same owner 195

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

View all 195

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684800000000",
    "number": "1760440424",
    "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": "704-644-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 PROFESSIONAL PKWY",
            "address_2": "SUITE A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309076529",
            "telephone_number": "706-868-4422",
            "fax_number": "706-868-4424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2311 E 1st St Ste B",
            "address_purpose": "LOCATION",
            "city": "Vidalia",
            "state": "GA",
            "postal_code": "304748811",
            "country_code": "US",
            "telephone_number": "912-537-2273",
            "fax_number": "912-537-2213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "143 US Highway 319 S",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317687991",
            "country_code": "US",
            "telephone_number": "229-217-0523",
            "fax_number": "229-217-4974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 S Main St",
            "address_purpose": "LOCATION",
            "city": "Hiawassee",
            "state": "GA",
            "postal_code": "305463472",
            "country_code": "US",
            "telephone_number": "706-896-1251",
            "fax_number": "706-896-1843",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5233 Riverside Dr Ste E",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312101253",
            "country_code": "US",
            "telephone_number": "478-476-4627",
            "fax_number": "478-476-4628",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4255 Wade Green Rd NW Ste 210",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301441810",
            "country_code": "US",
            "telephone_number": "770-529-8155",
            "fax_number": "770-529-8154",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7 Allen Cail Dr Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304582100",
            "country_code": "US",
            "telephone_number": "912-681-6838",
            "fax_number": "912-681-9912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "REGENCY HOSPICE OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A",
        "authorized_official_last_name": "COMBS",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "VP OF LEGAL AFFAIRS",
        "authorized_official_telephone_number": "913-814-2013"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "111637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000457509D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.