Serenity Point Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SERENITY POINT HOSPICE LLC

Practice address

762 E Chestnut St
Canton, IL 61520-2845

Phone

(309) 435-7050

NPI assigned

Dec 7, 2020

Last updated

Oct 7, 2021By 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

Dawn Marie Giacabazi

Title

Ceo/Partner

Phone

(309) 453-7050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831795632. Details of each certification follow.

• CCN 141708 Hospice · Active · Details

Hospice certification: CCN 141708

Legal name

SERENITY POINT HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 9, 2021

Last certification

Jun 9, 2021

Ownership / control type

Proprietary - Partnership

Organization structure

LLCProprietary

Incorporated

Dec 15, 2020 in IL

Enrollment address

762 E Chestnut St
Canton, IL 61520-2845

Listed as

Serenity Point Hospice LLCCCN 141708 · All quality measures

Ownership

For-Profit

Certified

Jun 9, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 4

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 2

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

• George B. Beranek, M.D.

  • Emergency Medicine Physician
  • Rockford, IL
  • NPI 1295716330

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership
• Gail D Williamson, MD

  • Internal Medicine Physician
  • Canton, IL
  • NPI 1376597732

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gail D Williamson, MD

  • Internal Medicine Physician
  • Canton, IL
  • NPI 1376597732
  Medicare reassignment NPD
• George B. Beranek, M.D.

  • Emergency Medicine Physician
  • Rockford, IL
  • NPI 1295716330
  NPD

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1831795632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "762 E CHESTNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202845",
            "telephone_number": "309-435-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 E CHESTNUT ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202845",
            "telephone_number": "309-435-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY POINT HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "GIACABAZI",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO/PARTNER",
        "authorized_official_telephone_number": "309-453-7050"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony J Scardina, PA-C
• Brian Scheil, RD, LDN
• Tessa R Schifferer, APRN
• Jessica Gail Schoon, LCSW
• Derek Schrodt
• William Severt, PT
• Gary Y. Shaw, M.D.
• Abby L. Sherwood, D.C.
• Tiffany Sigrist
• Kara Dean Simpson, LCSW

• Community Based Hospice Care Agency in Canton, IL
• Providers in Canton, IL by specialty
• Community Based Hospice Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.