Hospice Care Group, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HOSPICE CARE GROUP, LLC

Practice address

114 E Donald St
Quitman, MS 39355-2025

Phone

(601) 776-8880

Fax

(601) 776-8881

NPI assigned

Jul 13, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Theresa Lynn Zdenek, LPN

Title

Administrator

Phone

(601) 776-8880

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801812185. Details of each certification follow.

• CCN 251606 Hospice · Active · Details

Hospice certification: CCN 251606

Legal name

HOSPICE CARE GROUP LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 27, 2005

Last certification

Nov 20, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jan 14, 2005 in MS

Enrollment address

114E Donald St
Quitman, MS 39355-2025

Listed as

Hospice Care Group, LLCCCN 251606 · All quality measures

Ownership

For-Profit

Certified

Apr 27, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Muzaffar Rahat, M.D.

  • Internal Medicine Physician
  • Meridian, MS
  • NPI 1336145762

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Muzaffar Rahat, M.D.

  • Internal Medicine Physician
  • Meridian, MS
  • NPI 1336145762

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801812185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E DONALD ST",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552025",
            "telephone_number": "601-776-8880",
            "fax_number": "601-776-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E DONALD ST",
            "city": "QUITMAN",
            "state": "MS",
            "postal_code": "393552025",
            "telephone_number": "601-776-8880",
            "fax_number": "601-776-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE CARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ZDENEK",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "601-776-8880",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08673266",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Laboratory Corporation of America Holdings
• Enija Mays
• Kadejaih D McCarty
• Michael W Hubbert DMD, LLC

• Community Based Hospice Care Agency in Quitman, MS
• Providers in Quitman, MS by specialty
• Community Based Hospice Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.