NPIMap

Organization Active NPI

Hospice of Yancey County, Inc.

  • Community Based Hospice Care Agency
  • Burnsville, NC
National Provider Identifier
1760458657
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOS1027 Issued in NC
Legal business name
HOSPICE OF YANCEY COUNTY, INC.
Practice address
856 Georges Fork Rd
Burnsville, NC 28714-7842
Phone
(828) 682-9675
Fax
(828) 682-4713
NPI assigned
Feb 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Mr. Matthew V Grindstaff
Title
Ceo
Phone
(828) 682-9675

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
Community Based Hospice Care Agency 251G00000X HOS1027 NC Primary

Addresses

Primary practice location

856 Georges Fork Rd
Burnsville, NC 28714-7842

Mailing address

856 Georges Fork Rd
Burnsville, NC 28714-7842
Phone (828) 682-9675

Other identifiers 1

IdentifierTypeStateIssuer
3401564MedicaidNC

Other names 1

  • Compassionate Care Western North Carolina Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051101000806 NC Part A Provider - Hospice 3375560055 Practice locations: Burnsville, NC
O20160929000224 NC Part B Supplier - Clinic/Group Practice 3375560055 Receives reassigned benefits from 5 practitioners
Practice locations: Burnsville, NC

Hospice certification: CCN 341564

Legal name
HOSPICE OF YANCEY COUNTY INC
Doing business as
COMPASSIONATE CARE WESTERN NORTH CAROLINA
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 29, 1993
Last certification
Sep 11, 2019
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Nov 25, 1983 in NC
Enrollment address
856 Georges Fork Rd
Burnsville, NC 28714-7842

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Yancey CountyCCN 341564
Ownership
Non-Profit
Certified
Jul 29, 1993
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
34D0973484Hospice of Yancey County Inc856 Georges Fork Rd, Burnsville, NC 28714Certificate of waiverMay 7, 2028

National Provider Directory

National Provider Directory

Locations

856 Georges Fork Rd
Burnsville, NC 28714
Phone (828) 682-9675

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Jamie Lee McMahan Individual Corporate DirectorBoard Chair Jan 1, 2021
Brandi Marlene Burleson Individual Corporate DirectorBoard Secretary/Treasurer Jan 1, 2021
Matthew Grindstaff Individual Corporate Officer Jul 3, 2023
W-2 Managing Employee Jul 3, 2023
Dorothy J Bobbe Individual Corporate DirectorBoard Vice Chair Jan 1, 2021

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 8

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

Affiliated clinicians 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1760458657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 GEORGES FORK RD",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287147842",
            "telephone_number": "828-682-9675",
            "fax_number": "828-682-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 GEORGES FORK RD",
            "city": "BURNSVILLE",
            "state": "NC",
            "postal_code": "287147842",
            "telephone_number": "828-682-9675",
            "fax_number": "828-682-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF YANCEY COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "GRINDSTAFF",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-682-9675",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NC",
            "license": "HOS1027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3401564",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassionate Care Western North Carolina",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burnsville, NC

Sources for this page

Verify at the official NPI Registry.