NPIMap

Organization Active NPI

Phoebe Putney Memorial Hospital, Inc.

Doing business as Phoebe Hospice

  • Community Based Hospice Care Agency
  • Albany, GA
National Provider Identifier
1851356349
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.
Doing business as
Phoebe Hospice
Practice address
320 Foundation LN
Albany, GA 31707-5862
Phone
(229) 312-7050
Fax
(229) 312-7055
NPI assigned
Apr 19, 2006
Last updated
Jul 1, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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

Authorized official

Name
Brian Allen Church
Title
Cfo
Phone
(229) 312-4068

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary
Inpatient Hospice 315D00000X

Addresses

Primary practice location

320 Foundation LN
Albany, GA 31707-5862

Mailing address

320 Foundation LN
Albany, GA 31707-5862
Phone (229) 312-7050

Other identifiers 1

IdentifierTypeStateIssuer
000466001AMedicaidGA

Other names 1

  • Phoebe Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100716000560 GA Part A Provider - Hospice 4486559549 Practice locations: Albany, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851356349. Details of each certification follow.

Hospice certification: CCN 111527

Legal name
PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.
Doing business as
PHOEBE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 2, 1991
Last certification
Apr 21, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 10, 1990 in GA
Enrollment address
320 Foundation LN
Albany, GA 31707-5862

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Phoebe HospiceCCN 111527 · All quality measures
Ownership
Other
Certified
May 2, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Phoebe Putney Memorial Hospital30 organizations share this tax ID, including this one
Part of
Phoebe Putney Memorial Hospital

Other organizations with this tax ID 29

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

View all 29

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Chinyelu Ofodile Individual Corporate OfficerVolunteer Board Member Jan 9, 2025
Karen Thornton Individual Corporate OfficerVolunteer Board Member Apr 13, 2026
Marvin Laster Individual Corporate OfficerBoard Member Mar 1, 2019
Jenny Yin Savelle Individual Corporate OfficerBoard Member Apr 1, 2022
James E Black Individual Corporate OfficerVolunteer Board Member Jan 9, 2025
Margie Carder Individual W-2 Managing EmployeeAd; Sep 5, 2024
Phoebe Putney Health Systems Inc Organization, Albany, GA Non-profit 5% Or Greater Direct Ownership Interest May 14, 2010 100%
Chadalavada Kishore Individual Corporate OfficerMedical Director May 8, 2026
William J McAfee Individual Corporate OfficerBoard Member Mar 1, 2019
Pamela Green Jackson Individual Corporate OfficerBoard Member Apr 1, 2022
Scott Steiner Individual Corporate OfficerBoard Member Mar 1, 2019
Richard Doherty Individual Corporate OfficerVolunteer Board Member Apr 13, 2026
Derek J Heard Individual Corporate OfficerBoard Member Apr 1, 2022
William Griffin Individual Corporate OfficerVolunteer Board Member Jan 9, 2025
Brian a Church Individual Corporate OfficerCfo Aug 1, 2015
James Webb Individual Corporate OfficerBoard Member Mar 1, 2019
Tiera a Barron Individual Corporate OfficerVolunteer Board Member Jan 9, 2025

Owners & managing parties with NPI records 6

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

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467331200000",
    "number": "1851356349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 FOUNDATION LN",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317075862",
            "telephone_number": "229-312-7050",
            "fax_number": "229-312-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 FOUNDATION LN",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317075862",
            "telephone_number": "229-312-7050",
            "fax_number": "229-312-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOEBE PUTNEY MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-07-01",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-312-4068"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000466001A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phoebe Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.