Phoebe Putney Memorial Hospital Inc
Organization Active NPI Home Health Agency · Albany, GA
NPI 1790766863 · NPPES record last updated Dec 22, 2020
Key facts
- NPI
- 1790766863
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 088-140 (GA)
- Legal business name
- PHOEBE PUTNEY MEMORIAL HOSPITAL INC
- Practice address
- 810 14TH Ave
Albany, GA 31701-1304 - Phone
- (229) 312-9300
- NPI assigned
- Nov 7, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- PHOEBE PUTNEY MEMORIAL HOSPITAL INC
Authorized official
- Name
- Rebecca Kendall
- Title
- Director of Reimbursment
- Phone
- (229) 312-6711
Owners & managing parties with NPI records 5
-
Tiera Barron, M.D.
-
James E Black, MD
-
Derek J Heard, MD
-
Chinyelu Ofodile, D.O,
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 29
Facilities with the same owner 10
Practitioners 76
-
Nilofer A Ahsan, MD
-
Ayodeji Akadiri, MD
-
Kesha L Allen, MD
-
Ryann Beaumont, D.O.
-
James E Black, MD
-
Kelsey Bronson, LPC
-
Linda Joyce Carter-Sims, PMHNP
-
Robert Cella, MD
-
Cassandra S Edge, NP
-
Daniel Einhorn, MD
-
Kari L Fralish, NP
-
Rachel R French, NP
-
Sarah C Friend, M.D.
-
Sailaja Gadde, MD
-
Abigail Rose Glass, AGACNP-BC
Affiliated clinicians 40
-
Jason Gabriel Barnhart, M.D.
-
Tiera Barron, M.D.
-
James E Black, MD
-
Milica Bozovic, M.D.
-
John Michael Fennessy, M.D.
-
Charles F. Gebhardt, M.D.
-
Malcolm T Jefferson, MD, MS
-
Mana L Kasongo, MD
-
Shiny Teja Kolli, MD
-
Patrina Lockette, M.D.
-
Daniel Jason Martin, M.D.
-
Ifechukwude Nwadei, M.D
-
Chinyelu Ofodile, D.O,
-
Kofi Darkwa Seffah, M.D.
-
Sarah Stamper, D.O
Medicare Care Compare: Home health agency
- Listed as
- Phoebe Home Health
- Overall star rating
- ★★★☆☆ 3 of 5
- Ownership
- Non-Profit
- Certified
- Nov 19, 1991
- Medicare certification status
- Active
- Services
- Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Home health agency certification: CCN 117100
- Legal name
- PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.
- Doing business as
- PHOEBE HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Nov 19, 1991
- Last certification
- Oct 25, 2017
- Ownership / control type
- Non-Profit
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 10, 1990 in GA
- Enrollment address
- 810 14TH Ave
Albany, GA 31701-1304
All disclosed owners & managing parties 15
| Name | Role | Since | Share |
|---|---|---|---|
| Chinyelu Ofodile |
Corporate Officer |
Jan 9, 2025 | |
| Karen Thornton |
Corporate Officer |
Apr 13, 2026 | |
| Marvin Laster |
Corporate Officer |
Nov 30, 2017 | |
| Jenny Yin Savelle |
Corporate Officer |
Jan 1, 2023 | |
| James E Black |
Corporate Officer |
Jan 9, 2025 | |
| Phoebe Putney Health Systems Inc |
5% Or Greater Direct Ownership Interest | Nov 20, 2017 | 100% |
| William J McAfee |
Corporate Officer |
Nov 30, 2017 | |
| Pamela Green Jackson |
Corporate Officer |
Jan 1, 2023 | |
| Scott Steiner |
Corporate Officer |
Mar 1, 2019 | |
| Richard Doherty |
Corporate Officer |
Apr 13, 2026 | |
| Derek J Heard |
Corporate Officer |
Jan 1, 2023 | |
| William Griffin |
Corporate Officer |
Jan 9, 2025 | |
| Brian a Church |
Corporate Officer |
Aug 1, 2015 | |
| Operational/Managerial Control |
Aug 1, 2015 | ||
| James Webb |
Corporate Officer |
Nov 30, 2017 | |
| Tiera a Barron |
Corporate Officer |
Jan 9, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090603000107 | GA | Part a Provider - Home Health Agency | 4486559549 | Practice locations: Albany, GA; Americus, GA |
National Provider Directory
- Tax ID family
- Phoebe Putney Memorial
- Part of
- Phoebe Putney Memorial
Locations
804 14th Ave
Albany, GA 31701
320 Foundation Ln
Albany, GA 31707
Phone (229) 312-7050
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 088-140 | GA | Yes |
Addresses
Primary practice location
810 14TH Ave
Albany, GA 31701-1304
Mailing address
810 14TH Ave
Albany, GA 31701-1304
Phone (229) 312-9300
Other practice location 1
320 Foundation Ln
Albany, GA 31707-5862
Phone (229) 312-9300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00723709A | Medicaid | GA |
Other names
- PHOEBE HOME HEALTH
- Phoebe Home Care
Other providers in Albany, GA
- Phoebe Putney Memorial Hospital
- Phoebe Putney Memorial Hospital
- Phoebe Putney Memorial Hospital
- Phoebe Putney Memorial Hospital
- Phoebe Putney Memorial Hospital Inc
- Phoebe Putney Memorial Hospital Inc
- Phoebe Putney Memorial Hospital Inc
- Phoebe Putney Memorial Hospital, Inc
- Phoebe Putney Memorial Hospital, Inc.
- Phoebe Putney Memorial Hospital, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.