Organization Active NPI

Inspiring Hospice Partners of Georgia LLC

  • Community Based Hospice Care Agency
  • Watkinsville, GA
National Provider Identifier
1780105528
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
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

Updated by the provider on Sep 3, 2026

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
003207633AMedicaidGA

Other names 1

  • Bristol Hospice - East Georgia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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
LLCProprietary
Enrollment address
2053 Experiment Station Road
Building 500
Watkinsville, GA 30677-5459

Care Compare: Hospice

Medicare Care Compare
Listed as
Bristol Hospice- East GeorgiaCCN 111782
Ownership
For-Profit
Certified
Sep 13, 2016
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
11D2314402Inspiring Hospice Partners of Georgia, LLC119 Davis Road, Suite 1a, Martinez, GA 30907Certificate of waiverNov 18, 2026

National Provider Directory

National Provider Directory

Locations

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.

NameRoleSinceShare
Bristol Hospice Holdings Inc Organization, Salt Lake City, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
Nicole Wheeler Individual W-2 Managing EmployeeAd; Jul 24, 2017
Alex Edward Mauricio Individual Corporate OfficerPresident Ceo Jun 1, 2022
Corporate DirectorDirector Jan 1, 2023
Webster Equity Partners Bristol CF LP Organization, Waltham, MA For-profit, Private equity company 5% Or Greater Indirect Ownership Interest Jan 20, 2022 69.8%
John Charles Garbarino Individual Corporate OfficerSecretary/Treasurer Nov 1, 2021
Corporate DirectorDirector Oct 26, 2020
Webster Equity Partners IV Bristol CF LP Organization, Waltham, MA For-profit, Private equity company 5% Or Greater Indirect Ownership Interest Jan 20, 2022 5.72%
Michael Derrick Individual Corporate OfficerCfo Sep 1, 2023
Betty J Brennan Individual Corporate DirectorDirector Jul 13, 2018
Kirkland T Dodson Individual Contracted Managing EmployeeMedical Director Sep 24, 2021
Bristol Ultimate Holdco, LP Organization, Salt Lake City, UT Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jan 20, 2022 100%
Hyrum Kirton Individual Corporate DirectorDirector Oct 26, 2020
Aware Super Pty, LTD. Organization, Sydney, IN LLC, For-profit, Private equity company 5% Or Greater Indirect Ownership Interest May 9, 2022 8.28%
Bristol Hospice, L.L.C. Organization, Salt Lake City, UT LLC, Holding company, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Nov 1, 2021 100%
Bristol Hospice Topco Inc Organization, Salt Lake City, UT Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Nov 1, 2021 100%
David a Malm Individual Corporate OfficerVice President Nov 1, 2021
Corporate DirectorDirector 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.

Facilities with the same owner 52

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

View all 52

Change-of-ownership history 1

DateEventCounterparty
Jul 1, 2017 Change of OwnershipThis provider was the buyer Athena Hospice, LLCCCN 111782, GA, NPI 1710353198

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

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

Verify at the official NPI Registry.