Southeast Hospice Network, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOUTHEAST HOSPICE NETWORK, LLC

Practice address

3001 Zelda Rd Ste 300
Montgomery, AL 36106-2650

Phone

(334) 260-2916

NPI assigned

Jan 2, 2007

Last updated

May 20, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHEAST HOSPICE NETWORK, LLCAs reported in NPPES

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

Authorized official

Name

Debora Wilson, RN, BSN

Title

Executive Director

Phone

(205) 706-6809

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Southeast Hospice Network LLC

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.

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1851458830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 MCFARLAND BLVD N STE 503",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062204",
            "telephone_number": "205-366-9920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 ZELDA RD STE 300",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062650",
            "telephone_number": "334-260-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST HOSPICE NETWORK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHEAST HOSPICE NETWORK, LLC",
        "enumeration_date": "2007-01-02",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "205-706-6809",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sound Physicians Emergency Medicine of Alabama LLC
• South Central Alabama Development Commission
• Southeast Cancer Network, Inc (Cancer Care Center of Montgomery Jackson)
• Southeast Cancer Network, Inc
• Southeast Cancer Network, Inc
• Southeast Surgery, PC
• Southeastern Advanced Wound Care
• Southeastern Cardiology Consultants
• Southeastern Family Foot Care, LLC
• Southeastern Family Foot Care, LLC

• Community Based Hospice Care Agency in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Community Based Hospice Care Agency in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.