NPIMap

Organization Active NPI

Phoebe Sumter Medical Center, Inc.

Doing business as Phoebe Sumter Hospice

  • Community Based Hospice Care Agency
  • Americus, GA
National Provider Identifier
1780819235
Registry record updated Jun 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PHOEBE SUMTER MEDICAL CENTER, INC.
Doing business as
Phoebe Sumter Hospice
Practice address
126 E Furlow St
Americus, GA 31709-4027
Phone
(229) 928-4000
Fax
(229) 928-1322
NPI assigned
May 27, 2009
Last updated
Jun 24, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2009

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

Authorized official

Name
Mr. Kerry L. Loudermilk
Title
Sr. V.P. / Cfo
Phone
(229) 312-4068

Specialties & licenses 1

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

Addresses

Primary practice location

126 E Furlow St
Americus, GA 31709-4027

Mailing address

1048 E Forsyth St
Americus, GA 31709-3722
Phone (229) 931-1280

Other identifiers 1

IdentifierTypeStateIssuer
000629725AMedicaidGA

Other names 1

  • Phoebe Sumter Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100310000733 GA Part A Provider - Hospice 4385789213 Practice locations: Americus, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780819235. Details of each certification follow.

Hospice certification: CCN 111537

Legal name
PHOEBE SUMTER MEDICAL CENTER, INC.
Doing business as
PHOEBE SUMTER HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 3, 1994
Last certification
Oct 20, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 5, 2009 in GA
Enrollment address
126 E Furlow Street
Americus, GA 31709-4027

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Phoebe Sumter HospiceCCN 111537 · All quality measures
Ownership
Non-Profit
Certified
Aug 3, 1994
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Sumter Med Ctrinc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Michelle Doggett Individual W-2 Managing EmployeeController Mar 1, 2022
Bardin Hooks Individual Corporate OfficerVolunteer Board Member Mar 1, 2022
Dilbon Smith Individual Corporate OfficerVolunteer Board Member Jan 9, 2025
Michelle Johnston Individual Corporate OfficerVolunteer Board Member Jan 8, 2026
John Lumpkin Crisp Individual Corporate OfficerVolunteer Board Member Mar 1, 2022
Sandra L Zornes Individual Corporate OfficerVolunteer Board Member Mar 1, 2022
Phoebe Putney Health Systems Inc Organization, Albany, GA Non-profit Operational/Managerial Control Jul 1, 2009 100%
Angela Holt Individual Corporate OfficerVolunteer Board Member Jan 9, 2025
Scott Steiner Individual Corporate OfficerBoard Member Mar 1, 2019
Brian a Church Individual Corporate OfficerSenior Administrator and Cfo Mar 1, 2022
Sandra K Daniel Individual Corporate OfficerVolunteer Board Member Mar 31, 2022
Fredrick McLaughlin Individual Corporate OfficerVolunteer Board Member Jul 1, 2009
Carlyle Walton Individual Corporate OfficerCeo Oct 31, 2022

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 10

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245801600000",
    "number": "1780819235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 E FORSYTH ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093722",
            "telephone_number": "229-931-1280",
            "fax_number": "229-924-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E FURLOW ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317094027",
            "telephone_number": "229-928-4000",
            "fax_number": "229-928-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE SUMTER MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-06-24",
        "status": "A",
        "authorized_official_last_name": "LOUDERMILK",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SR. V.P. / CFO",
        "authorized_official_telephone_number": "229-312-4068",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000629725A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Sumter Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Americus, GA

Sources for this page

Verify at the official NPI Registry.