Quality Hospice Care, Inc
Organization Active NPI Community Based Hospice Care Agency · Philadelphia, MS
NPI 1902805161 · NPPES record last updated Aug 14, 2007
Key facts
- NPI
- 1902805161
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 086 (MS)
- Legal business name
- QUALITY HOSPICE CARE, INC
- Practice address
- 340 Byrd Ave S
Philadelphia, MS 39350-2516 - Phone
- (601) 656-5252
- Fax
- (601) 656-5253
- NPI assigned
- Jul 19, 2005
- Organization subpart
- No
Authorized official
- Name
- Mrs. Joann T. Rounsaville, LBSW
- Title
- President
- Phone
- (601) 656-5252
Affiliated clinicians 21
-
Laura E Alexander, D.O.
-
Russell E. Belenchia, D.O.
-
Heather Cannon, M.D.
-
Patrick Eakes, MD
-
Todd L Fulcher, MD
-
James D Gentry, MD
-
Michael G Holman, MD
-
James W. Lock, MD
-
Manuel Lim Ong Jr., M.D.
-
Samuel Keith Suttle, M.D.
-
Helen I Turner, MD
-
Daniel Lee Armistead, M.D.
-
John Michael Miller II, M.D.
Medicare Care Compare: Hospice
- Listed as
- Quality Hospice Care, Inc
- Ownership
- For-Profit
- Certified
- Jul 3, 2003
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Hospice certification: CCN 251580
- Legal name
- QUALITY HOSPICE CARE, INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 3, 2003
- Last certification
- Jan 23, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation · Proprietary
- Incorporated
- Apr 14, 2003 in MS
- Enrollment address
- 317 Range Ave
Philadelphia, MS 39350-2670
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Jo Ann Rounsaville |
5% Or Greater Direct Ownership Interest | Apr 14, 2003 | 50% |
| Corporate Officer |
Apr 13, 2003 | 50% | |
| Rex Rounsaville |
5% Or Greater Direct Ownership Interest | Apr 14, 2003 | 10% |
| Corporate Officer |
Apr 13, 2003 | 10% | |
| Tyler Rounsaville |
5% Or Greater Direct Ownership Interest |
Jul 1, 2019 | 40% |
| Corporate Officer |
Jul 1, 2019 | 40% | |
| Corporate Director |
Oct 1, 2009 | 40% | |
| Operational/Managerial Control |
Jul 1, 2019 | 40% | |
| Ann Barefield |
W-2 Managing Employee |
Oct 5, 2009 | 25% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20091026000486 | MS | Part a Provider - Hospice | 9739099185 | Practice locations: Philadelphia, MS |
National Provider Directory
Locations
1413 23rd Ave
Meridian, MS 39301
Phone (601) 693-0103
340 Byrd Ave S
Philadelphia, MS 39350
Phone (601) 656-5252
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 086 | MS | Yes |
Addresses
Primary practice location
340 Byrd Ave S
Philadelphia, MS 39350-2516
Mailing address
340 Byrd Ave S
Philadelphia, MS 39350-2516
Phone (601) 656-5252
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02755291 | Medicaid | MS |
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- Matthew B Purvis
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All providers in Philadelphia, MS · Community Based Hospice Care Agency in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.