NPIMap

Organization Active NPI

St. Mary'S Hospital of St. Mary'S County, Inc.

  • Community Based Hospice Care Agency
  • Callaway, MD
National Provider Identifier
1790746444
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
H1539 Issued in MD
Legal business name
ST. MARY'S HOSPITAL OF ST. MARY'S COUNTY, INC.
Practice address
44724 Hospice Lane
Callaway, MD 20620
Phone
(301) 994-3023
Fax
(301) 475-6188
NPI assigned
Mar 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Authorized official

Name
Mr. Michael Meisel
Title
Cfo
Phone
(202) 503-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X H1539 MD Primary

Addresses

Primary practice location

44724 Hospice Lane
Callaway, MD 20620

Mailing address

44724 Hospice Lane
Callaway, MD 20620
Phone (301) 994-3023

Other identifiers 1

IdentifierTypeStateIssuer
600902603MedicaidMD

Other names 1

  • Hospice of St. Mary's Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130801000589 MD Part A Provider - Hospice 4789589912 Practice locations: Callaway, MD

Hospice certification: CCN 211539

Legal name
ST MARYS HOSPITAL OF ST MARYS COUNTY INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 19, 1998
Last certification
Jun 23, 2017
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Mar 13, 1912 in MD
Enrollment address
44724 Hospice Lane
Callaway, MD 20620-2078

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
Hospice of St Mary'SCCN 211539
Ownership
Other
Certified
Nov 19, 1998
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
21D2005048Hospice of St Mary'S44724 Hospice Lane, Callaway, MD 20620Certificate of waiverMar 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
St Mary'S Hospital Specialists12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

44724 Hospice Ln
Callaway, MD 20620
Phone (301) 994-3023

29955 Three Notch Rd
Fl 2
Charlotte Hall, MD 20622
Phone (301) 475-6195

20945 Great Mills Rd
Ste 203
Lexington Pk, MD 20653
Phone (240) 237-8557

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Barbara R Thompson Individual Corporate DirectorChairman Board of Directors Oct 1, 2009
Mary L Harless Individual Corporate DirectorBoard Member Oct 1, 2009
Donald Cather Individual Corporate DirectorBoard Member Oct 1, 2009
Conor F Lundergan Individual Corporate DirectorBoard Member Jan 1, 2013
Avani Shah Individual Corporate DirectorBoard Member Jan 1, 2012
Melanie L Guerrero Individual Corporate DirectorBoard Member Nov 1, 2012
Jennifer Blake Individual Corporate DirectorBoard Member Nov 15, 2012
Kara Rawlings Individual W-2 Managing EmployeeDirector of Hospice Jan 1, 2021
Timothy Storch Individual Corporate DirectorBoard Member Treasurer Oct 1, 2009
Jane Sypher Individual Corporate DirectorBoard Member Oct 1, 2009
Patty Vernon Rusher Individual Corporate DirectorBoard Member Dec 1, 2005
Krishna P Jayaraman Individual Corporate DirectorBoard Member Nov 1, 2012
Christina Broom Individual Corporate DirectorBoard Member Apr 1, 2013
Christine Wray Individual Corporate DirectorBoard Member Oct 1, 2009

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medstar St. Mary'S HospitalLeonardtown, MD, CCN 210028 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Sep 30, 2009
Sep 30, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1143763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1790746444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44724 HOSPICE LANE",
            "city": "CALLAWAY",
            "state": "MD",
            "postal_code": "20620",
            "telephone_number": "301-994-3023",
            "fax_number": "301-475-6188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44724 HOSPICE LANE",
            "city": "CALLAWAY",
            "state": "MD",
            "postal_code": "20620",
            "telephone_number": "301-994-3023",
            "fax_number": "301-475-6188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. MARY'S HOSPITAL OF ST. MARY'S COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-31",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "MEISEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "202-503-8720",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MD",
            "license": "H1539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600902603",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of St. Mary's",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice of St. Mary's",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Callaway, MD

Sources for this page

Verify at the official NPI Registry.