Bedford Memorial Hospital

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

EXEMPT Issued in NU

Legal business name

BEDFORD MEMORIAL HOSPITAL

Doing business as

Bedford Hospice Care

Practice address

1621 Whitfield Dr
Suite C
Bedford, VA 24523-1519

Phone

(434) 200-1816

Fax

(434) 200-6638

NPI assigned

Jun 9, 2014

Last updated

May 8, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

CENTRA HEALTH INCAs reported in NPPES

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

Authorized official

Name

Mr. Lewis C Addison

Title

SVP Cfo

Phone

(434) 200-4708

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Bedford Hospice Care Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841603776. Details of each certification follow.

• CCN 491552 Hospice · Active · Details

Hospice certification: CCN 491552

Legal name

BEDFORD MEMORIAL HOSPITAL

Doing business as

CENTRA BEDFORD HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 4, 1999

Last certification

Jun 9, 2021

Ownership / control type

Other

Organization structure

LLCNon-profit

Incorporated

May 20, 2014 in VA

Enrollment address

1621 Whitfield Drive
Suite C
Bedford, VA 24523-2636

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Bedford Memorial Hospital

  dba Centra Bedford Hospice

  • Community Based Hospice Care Agency
  • Bedford, VA
  • NPI 1770576118

  O20030328000004

  Same enrollment

Listed as

Centra Bedford HospiceCCN 491552 · All quality measures

Ownership

Non-Profit

Certified

Mar 4, 1999

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Bedford Memorial Hospital4 organizations share this tax ID, including this one

Part of

Centra Lab

Other organizations with this tax ID 3

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

• Bedford Memorial Hospital

  • General Acute Care Hospital
  • Bedford, VA
  • NPI 1295728491
  NPD tax ID
• Bedford Post Acute Services LLC

  dba Oakwood Health & Rehabilitation Center

  • Skilled Nursing Facility
  • Bedford, VA
  • NPI 1386057420
  NPD tax ID
• Bedford Post Acute Services LLC

  dba Bedford Adult Day Center

  • Developmentally Disabled Services Day Training Agency
  • Bedford, VA
  • NPI 1679986731
  NPD tax ID

Locations

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.

Owners & managing parties with NPI records 2

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

• Hilary Fitzgerald Basham, D.O.

  • Emergency Medicine Physician
  • Bedford, VA
  • NPI 1235335886

  Corporate Director

  CMS ownership
• Brenda L. Stokes, M.D.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Lynchburg, VA
  • NPI 1861491136

  W-2 Managing Employee

  CMS ownership

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1841603776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 ATHERHOLT RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011104",
            "telephone_number": "434-200-1816",
            "fax_number": "434-200-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 WHITFIELD DR",
            "address_2": "SUITE C",
            "city": "BEDFORD",
            "state": "VA",
            "postal_code": "245231519",
            "telephone_number": "434-200-1816",
            "fax_number": "434-200-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEDFORD MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRA HEALTH INC",
        "enumeration_date": "2014-06-09",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SVP CFO",
        "authorized_official_telephone_number": "434-200-4708",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": "EXEMPT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004910435",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "005",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "147124",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "337476",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bedford Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Bedford Memorial Hospital
• Bedford Memorial Hospital
• Bedford Memorial Hospital
• Bedford Memorial Hospital (Centra Bedford Hospice)
• Bedford Memorial Hospital (Bedford Adult Day Center)
• Bedford Memorial Hospital
• Bedford Podiatry & Foot Surgery, P.C.
• Bedford Post Acute Services LLC (Oakwood Health & Rehabilitation Center)
• Bedford Post Acute Services LLC (Bedford Adult Day Center)
• Bedford Prescription Services (Medicine Shoppe)

• Community Based Hospice Care Agency in Bedford, VA
• Providers in Bedford, VA by specialty
• Community Based Hospice Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.