Active NPI
Inspiring Hospice Partners of Georgia LLC
- Community Based Hospice Care Agency
- Watkinsville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- INSPIRING HOSPICE PARTNERS OF GEORGIA LLC
- Practice address
- 2053 Experiment Station Rd Ste 500
Watkinsville, GA 30677-5459 - Phone
- (706) 850-9300
- NPI assigned
- Jul 1, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alex Mauricio
- Title
- President/Ceo
- Phone
- (801) 325-0175
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | GA | ||
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
2053 Experiment Station Rd Ste 500
Watkinsville, GA 30677-5459
Mailing address
2053 Experiment Station Rd Ste 500
Watkinsville, GA 30677-5459
Phone (706) 850-9300
Other practice location 1
119 Davis Rd Ste 1A
Martinez, GA 30907-0201
Phone (706) 240-8320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003207633A | Medicaid | GA |
Other names 1
- Bristol Hospice - East Georgia
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170925002842 | GA | Part A Provider - Hospice | 5890069132 | Practice locations: Martinez, GA; Watkinsville, GA |
Hospice certification: CCN 111782
- Legal name
- INSPIRING HOSPICE PARTNERS OF GEORGIA LLC
- Doing business as
- BRISTOL HOSPICE - EAST GEORGIA
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 13, 2016
- Last certification
- Jun 20, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Enrollment address
- 2053 Experiment Station Road
Building 500
Watkinsville, GA 30677-5459
Care Compare: Hospice
Medicare Care Compare- Listed as
- Bristol Hospice- East Georgia
- Ownership
- For-Profit
- Certified
- Sep 13, 2016
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2314402 | Inspiring Hospice Partners of Georgia, LLC | Certificate of waiver | Nov 18, 2026 |
National Provider Directory
National Provider DirectoryLocations
119 Davis Rd
Ste 1A
Martinez, GA 30907
Phone (706) 240-8320
1252 Virgil Langford Rd
Watkinsville, GA 30677
Phone (706) 850-9300
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 100% |
| Nicole Wheeler | W-2 Managing Employee | Jul 24, 2017 | |
| Alex Edward Mauricio | Corporate Officer | Jun 1, 2022 | |
| Corporate Director | Jan 1, 2023 | ||
| Webster Equity Partners Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 20, 2022 | 69.8% |
| John Charles Garbarino | Corporate Officer | Nov 1, 2021 | |
| Corporate Director | Oct 26, 2020 | ||
| Webster Equity Partners IV Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 20, 2022 | 5.72% |
| Michael Derrick | Corporate Officer | Sep 1, 2023 | |
| Betty J Brennan | Corporate Director | Jul 13, 2018 | |
| Kirkland T Dodson | Contracted Managing Employee | Sep 24, 2021 | |
| Bristol Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | Jan 20, 2022 | 100% |
| Hyrum Kirton | Corporate Director | Oct 26, 2020 | |
| Aware Super Pty, LTD. | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 8.28% |
| Bristol Hospice, L.L.C. | 5% Or Greater Direct Ownership Interest | Nov 1, 2021 | 100% |
| Bristol Hospice Topco Inc | 5% Or Greater Indirect Ownership Interest | Nov 1, 2021 | 100% |
| David a Malm | Corporate Officer | Nov 1, 2021 | |
| Corporate Director | Oct 26, 2020 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Washington, GA
- NPI 1689745960
Contracted Managing Employee
Facilities with the same owner 52
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Atlanta, GA
- NPI 1558663872
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bangor, ME
- NPI 1336916469
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bend, OR
- NPI 1356916845
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Plymouth Meeting, PA
- NPI 1356118467
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Merced, CA
- NPI 1487603452
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- North Charleston, SC
- NPI 1326866963
Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Des Plaines, IL
- NPI 1104548478
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Springfield, OR
- NPI 1568962033
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Green Bay, WI
- NPI 1356928154
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Honolulu, HI
- NPI 1811045594
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Riverside, CA
- NPI 1043683170
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Ontario, CA
- NPI 1013318112
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
Change-of-ownership history 1
| Date | Event | Counterparty |
|---|---|---|
| Jul 1, 2017 | Change of Ownership | Athena Hospice, LLC |
Change of ownership 1
Medicare changes of ownership in which this facility was the buyer or the seller.
-
- Community Based Hospice Care Agency
- Athens, GA
- NPI 1710353198
Acquired from, 2017-07-01
Practitioners & affiliated clinicians
Affiliated clinicians 6
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498867200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788393600000",
"number": "1780105528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2053 EXPERIMENT STATION RD STE 500",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306775459",
"telephone_number": "706-850-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2053 EXPERIMENT STATION RD STE 500",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306775459",
"telephone_number": "706-850-9300"
}
],
"practiceLocations": [
{
"address_1": "119 Davis Rd Ste 1A",
"address_purpose": "LOCATION",
"city": "Martinez",
"state": "GA",
"postal_code": "309070201",
"country_code": "US",
"telephone_number": "706-240-8320",
"fax_number": "706-341-0347",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "INSPIRING HOSPICE PARTNERS OF GEORGIA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-07-01",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A",
"authorized_official_last_name": "MAURICIO",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT/CEO",
"authorized_official_telephone_number": "801-325-0175"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "GA",
"license": null,
"primary": false
},
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003207633A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bristol Hospice - East Georgia",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Watkinsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.