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Organization Active NPI

Community Care Hospice LLC

Doing business as Community Care Hospice

  • Inpatient Hospice
  • Hammond, LA
National Provider Identifier
1912081217
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient HospiceTaxonomy code 315D00000X
Legal business name
COMMUNITY CARE HOSPICE LLC
Doing business as
Community Care Hospice
Practice address
1007 W Thomas St
Suite a
Hammond, LA 70401-3062
Phone
(985) 340-1880
Fax
(985) 340-7872
NPI assigned
Oct 24, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Shannon Dillon
Title
Owner
Phone
(985) 340-1880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Hospice 315D00000X Primary

Addresses

Primary practice location

1007 W Thomas St
Suite a
Hammond, LA 70401-3062

Mailing address

1007 W Thomas St
Suite a
Hammond, LA 70401-3062
Phone (985) 340-1880

Other identifiers 1

IdentifierTypeStateIssuer
1459810MedicaidLA

Other names 1

  • Community Care Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061207000124 LA Part A Provider - Hospice 6507865243 Practice locations: Franklinton, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912081217. Details of each certification follow.

Hospice certification: CCN 191633

Legal name
COMMUNITY CARE HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 21, 2006
Last certification
Aug 26, 2021
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Sep 15, 2006 in LA
Enrollment address
2124 Washington St
Franklinton, LA 70438-2544

Care Compare: Hospice

Medicare Care Compare
Listed as
Community Care HospiceCCN 191633 · All quality measures
Ownership
Other
Certified
Dec 21, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1019 N Range Ave
Ste D
Denham Springs, LA 70726
Phone (225) 655-6444

1007 W Thomas St
Ste A
Hammond, LA 70401
Phone (985) 340-1880

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Shannon Dillon Individual 5% Or Greater Direct Ownership InterestCfo/Owner Oct 3, 2006 75%
General Partnership Interest Oct 3, 2006
Paula Painter Individual W-2 Managing EmployeeAd;Director of Nursing Sep 13, 2021 50%
Harold Palma Individual 5% Or Greater Direct Ownership InterestOwner/Liason Oct 3, 2006 25%
General Partnership Interest Oct 3, 2006
Eric a Payne Individual Contracted Managing EmployeeMD; May 13, 2025

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

Affiliated clinicians 5

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": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1912081217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 W THOMAS ST",
            "address_2": "SUITE A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704013062",
            "telephone_number": "985-340-1880",
            "fax_number": "985-340-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 W THOMAS ST",
            "address_2": "SUITE A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704013062",
            "telephone_number": "985-340-1880",
            "fax_number": "985-340-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-340-1880",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1459810",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.