Grace Hospice and Palliative Care, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2203782734 Issued in LA

Legal business name

GRACE HOSPICE AND PALLIATIVE CARE, LLC

Practice address

217 Rue Louis Xiv Ste 100
Lafayette, LA 70508-5778

Phone

(337) 948-9004

NPI assigned

Apr 10, 2018

Organization subpart

No

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

Authorized official

Name

Timothy Bergeron

Title

Ceo

Phone

(337) 948-9004

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Traditions Hospice of Lafayette, LLC

  • Community Based Hospice Care Agency
  • Lafayette, LA
  • NPI 1578169819

  Sold to, 2020-12-31

  CMS change of ownership

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1902303647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 RUE LOUIS XIV STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 RUE LOUIS XIV STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085778",
            "telephone_number": "337-948-9004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOSPICE AND PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-11-27",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "BERGERON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-948-9004"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "2203782734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031780",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1066.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "'CMS esMD eMDR'",
            "address_1": "8215 W 108th Ter",
            "city": "Overland Park",
            "state": "KS",
            "country_code": "US",
            "postal_code": "662101661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shiho Goto, ATC
• Bryan Gottshall
• Anita J Gouri, D.D.S.
• Grace Counseling and Wellness LLC
• Grace Gynecology & Wellness Corp Apmc
• Grace Palliative Care LLC
• David Michael Grace, M.D.
• Graceful Balance Counseling and Consulting LLC
• Gracefully Grounded LLC
• Graciana Counseling

• Community Based Hospice Care Agency in Lafayette, LA
• Providers in Lafayette, 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 Nov 27, 2023; 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.