Canon Hospice-North Shore, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CANON HOSPICE-NORTH SHORE, LLC

Doing business as

canon hospice

Practice address

4045A Desoto St
Mandeville, LA 70471-1850

Phone

(504) 669-3825

Fax

(504) 899-2377

NPI assigned

May 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Shiva Kumar Akula, M.D

Title

President

Phone

(504) 669-3825

Specialties & licenses 1

Addresses

Other names 1

• canon hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Southern Grace Hospice North LLC

  • Community Based Hospice Care Agency
  • Hammond, LA
  • NPI 1093522245

  Sold to, 2024-12-04

  CMS change of ownership

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

{
    "created_epoch": "1180224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881805059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850715",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701850715",
            "telephone_number": "504-669-3825",
            "fax_number": "504-899-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4045A DESOTO ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711850",
            "telephone_number": "504-669-3825",
            "fax_number": "504-899-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANON HOSPICE-NORTH SHORE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AKULA",
        "authorized_official_first_name": "SHIVA",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-669-3825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "canon hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracy Callihan
• Delaney Campagna
• Kayla Campbell
• Whitney Lin Campbell
• Jackie A. Campo, B.S.
• Jennifer May Cantrell, DNP, APRN, FNP-C
• Kenneth J Capone, M.D.
• Cardiomed Consultants, LLC
• Cardiopulmonaryfit, LLC
• Cardium Diagnostics LLC

• Community Based Hospice Care Agency in Mandeville, LA
• Providers in Mandeville, LA by specialty
• Community Based Hospice Care Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.