Hospice of Chenango County, Inc.
Organization Active NPI Community Based Hospice Care Agency · Norwich, NY
NPI 1821095902 · NPPES record last updated May 22, 2013
Key facts
- NPI
- 1821095902
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 0824500F (NY)
- Legal business name
- HOSPICE OF CHENANGO COUNTY, INC.
- Practice address
- 21 Hayes St
Norwich, NY 13815-1617 - Phone
- (607) 334-3556
- Fax
- (607) 334-3688
- NPI assigned
- Jul 5, 2005
- Organization subpart
- No
Authorized official
- Name
- Ms. Patricia M Outhouse, BS, MA
- Title
- Executive Director
- Phone
- (607) 334-3556
Practitioners 1
-
Kiernan L. Hamilton, LCSW-R
Affiliated clinicians 7
-
Zaki Badawy, MD
-
Khalid Rashid Butt, M.D.
-
Jeffrey M Hughes, MD
-
Mark Makar, MD
-
Anna Marie Ward, MD
-
Kurt R Harding, D.O.
Medicare Care Compare: Hospice
- Listed as
- Hospice & Palliative Care of Chenango County Inc.
- Ownership
- Non-Profit
- Certified
- Oct 31, 1991
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Hospice certification: CCN 331548
- Legal name
- HOSPICE OF CHENANGO COUNTY INC
- Doing business as
- HOSPICE & PALLIATIVE CARE OF CHENANGO COUNTY INC.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 31, 1991
- Last certification
- Nov 6, 2020
- Ownership / control type
- Other
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 15, 1989 in NY
- Enrollment address
- 33-39 Court St
Norwich, NY 13815-1325
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Zachery Meseck |
Corporate Director | Jan 1, 2022 | |
| Carol Stanboro |
Corporate Director | Jan 1, 2022 | |
| Kendall B Johnson |
Corporate Director |
Apr 1, 2017 | |
| W-2 Managing Employee |
Apr 1, 2017 | ||
| Hospice of Chenango County Inc |
Operational/Managerial Control | Nov 15, 1989 | 100% |
| Brian Wessels |
Corporate Director | Jan 1, 2022 | |
| Wayne Tilley |
Corporate Officer |
Jan 1, 2021 | |
| Corporate Director | Jan 1, 2021 | ||
| David H Kirsch |
Corporate Director | Jan 1, 2018 | |
| Erin Cole |
Corporate Director | Jan 1, 2022 | |
| Theresa Davis |
Corporate Director | Jan 1, 2021 | |
| Alexandra C Erath |
Corporate Director |
Mar 31, 2017 | |
| Grady Thompson |
Corporate Director | Jan 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130514000763 | NY | Part a Provider - Hospice | 3476790213 | Practice locations: Norwich, NY |
National Provider Directory
Locations
21 Hayes St
Norwich, NY 13815
Phone (607) 334-3556
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 0824500F | NY | Yes |
Addresses
Primary practice location
21 Hayes St
Norwich, NY 13815-1617
Mailing address
21 Hayes St
Norwich, NY 13815-1617
Phone (607) 334-3556
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01268400 | Medicaid | NY |
Other names
- Hospice & Palliative Care of Chenango County
Other providers in Norwich, NY
- Fawn M Holland
- Grace D Holmes
- Thomas R Holmes
- Linda J Horovitz
- Michelle Ruth Horton-Benenati
- Chelsea Elizabeth Hough
- Kelli K Howe
- Karlee Hoyt
- David Alan Hughes
- Kristina Hummer
All providers in Norwich, NY · Community Based Hospice Care Agency in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2013. 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.