NPIMap

Organization Active NPI

Autumn View Hospice, LLC

  • Community Based Hospice Care Agency
  • Snellville, GA
National Provider Identifier
1891387619
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AUTUMN VIEW HOSPICE, LLC
Practice address
1350 Scenic Hwy N Ste 266
Snellville, GA 30078-7924
Phone
(678) 808-4047
Fax
(404) 475-5756
NPI assigned
Feb 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Mrs. Sherry Bynum Smith, BSN, RNNPI 1538725197
Title
Administrator
Phone
(269) 744-2980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1350 Scenic Hwy N Ste 266
Snellville, GA 30078-7924

Mailing address

2013 Great Shoals Cir
Lawrenceville, GA 30045-2718
Phone (470) 475-5756

Other practice location 1

1350 Scenic Hwy N Ste 266
Snellville, GA 30078-7924
Phone (470) 475-5756

Other names 1

  • Autumn View Hospice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL autumnveiewhospice@gmail.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210416000312 GA Part A Provider - Hospice 7517375348 Practice locations: Snellville, GA

Hospice certification: CCN 851546

Legal name
AUTUMN VIEW HOSPICE, LLC
Doing business as
AUTUMN VIEW HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 7, 2021
Last certification
Jun 30, 2021
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
May 14, 2020 in GA
Enrollment address
1350 Scenic Hwy N
Ste 266
Snellville, GA 30078-7924

Care Compare: Hospice

Medicare Care Compare
Listed as
Autumn View Hospice, LLCCCN 851546
Ownership
For-Profit
Certified
Jul 7, 2021
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Ownership & related parties

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.

NameRoleSinceShare
Eric D Hamilton Individual 5% Or Greater Direct Ownership InterestMedical Director May 14, 2020 33.3%
Lavell Hewitt Individual 5% Or Greater Direct Ownership InterestCfo May 14, 2020 33.4%
W-2 Managing EmployeeCfo May 14, 2020 33.4%
Sherry Smith Individual 5% Or Greater Direct Ownership InterestAdministrator May 14, 2020 33.3%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

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": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1891387619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 GREAT SHOALS CIR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300452718",
            "telephone_number": "470-475-5756",
            "fax_number": "404-795-0744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SCENIC HWY N STE 266",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787924",
            "telephone_number": "678-808-4047",
            "fax_number": "404-475-5756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 Scenic Hwy N Ste 266",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300787924",
            "country_code": "US",
            "telephone_number": "470-475-5756",
            "fax_number": "404-795-0744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AUTUMN VIEW HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_middle_name": "BYNUM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "269-744-2980",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "autumnveiewhospice@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Company email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "useOtherDescription": "(404) 795-0744",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Fax",
            "address_1": "1350 Scenic Hwy N Ste 266",
            "city": "Snellville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300787924",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Autumn View Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Autumn View Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.