Family Hospice of Belleville Area

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2001089 Issued in IL

Legal business name

FAMILY HOSPICE OF BELLEVILLE AREA

Practice address

5110 West Main Street
Belleville, IL 62226-4729

Phone

(618) 277-1800

Fax

(618) 277-1074

NPI assigned

Jul 29, 2006

Organization subpart

No

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

Authorized official

Name

Jim Clindaniel, LNHA

Title

Executive Director

Phone

(618) 277-1800

Specialties & licenses 1

Addresses

Other names 1

• Family Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Hospice certification: CCN 141544

Legal name

FAMILY HOSPICE OF BELLEVILLE AREA

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 1, 1991

Last certification

Oct 20, 2021

Ownership / control type

Non-Profit - Private

Organization structure

CorporationNon-profit

Incorporated

May 6, 1991 in IL

Enrollment address

5110W Main St
Belleville, IL 62226-4729

Listed as

Family Hospice of Belleville AreaCCN 141544

Ownership

Non-Profit

Certified

Aug 1, 1991

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 12

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

Practitioners 1

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

• Srinivasarao C Yaganti, M.D.

  • Hospitalist Physician
  • Belleville, IL
  • NPI 1245252972
  NPD (past)

Affiliated clinicians 1

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

• Srinivasarao C Yaganti, M.D.

  • Hospitalist Physician
  • Belleville, IL
  • NPI 1245252972

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891700720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 WEST MAIN STREET",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264729",
            "telephone_number": "618-277-1800",
            "fax_number": "618-277-1074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 WEST MAIN STREET",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622264729",
            "telephone_number": "618-277-1800",
            "fax_number": "618-277-1074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HOSPICE OF BELLEVILLE AREA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLINDANIEL",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-277-1800",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IL",
            "license": "2001089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eyecare Management, LLC
• Eyecare of Illinois LTD
• Morgan Fahey-Vornberg, D.O.
• Kiley M Faires, FNP-BC
• Family First Health Center PC
• Enrico T. Farinas, MD
• Forrest M Farr, DDS
• Robert J Fast, DC
• Snowber Fazili, DMD
• Michael Gregory Fazio, DO

• Community Based Hospice Care Agency in Belleville, IL
• Providers in Belleville, IL by specialty
• Community Based Hospice Care Agency in Illinois

• 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.
• 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.