Active NPI
Amity Care, LLC
- Community Based Hospice Care Agency
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 29670
- Legal business name
- AMITY CARE, LLC
- Practice address
- 161 Village Pkwy NE BLDG 7
Marietta, GA 30067 - Phone
- (678) 402-5235
- Fax
- (770) 818-5428
- NPI assigned
- Sep 25, 2009
- Last updated
- Jul 26, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ahmad Ghadamyari
- Title
- Ceo
- Phone
- (678) 402-5235
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 29670 | GA | Primary |
Addresses
Primary practice location
161 Village Pkwy NE BLDG 7
Marietta, GA 30067
Mailing address
161 Village Pkwy NE BLDG 7
Marietta, GA 30067-4061
Phone (678) 402-5235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1942534722. Details of each certification follow.
Hospice certification: CCN 111692
- Legal name
- AMITY CARE, LLC
- Doing business as
- AMITY CARE HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Apr 1, 2010
- Last certification
- Dec 7, 2021
- Ownership / control type
- Other
- Organization structure
- LLC
- Incorporated
- Oct 24, 2008 in GA
- Enrollment address
- 161 Village Pkwy NE
BLDG 7
Marietta, GA 30067-4061
Care Compare: Hospice
Medicare Care Compare- Listed as
- Amity Care
- Ownership
- Other
- Certified
- Apr 1, 2010
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
161 Village Pkwy NE
#7
Marietta, GA 30067
Phone (678) 402-5235
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Thomas John Demarco | Contracted Managing Employee | Apr 10, 2016 | 50% |
| Vickie N Ghadamyari | W-2 Managing Employee | Apr 22, 2015 | |
| Lee Wilkes | Contracted Managing Employee | Jan 1, 2018 | 50% |
| Ahmad Ghadamyari | 5% Or Greater Direct Ownership Interest | Sep 12, 2008 | 100% |
| W-2 Managing Employee | Oct 24, 2008 | 100% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Gastroenterology Physician
- Smyrna, GA
- NPI 1093825846
Contracted Managing Employee
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Nurse Practitioner
- Marietta, GA
- NPI 1437581568
-
- Gerontology Nurse Practitioner
- Tucker, GA
- NPI 1164783080
-
- Family Nurse Practitioner
- Tucker, GA
- NPI 1881129807
-
- Family Nurse Practitioner
- Kennesaw, GA
- NPI 1831638006
Affiliated clinicians 1
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": "1253836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1532563200000",
"number": "1942534722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "161 VILLAGE PKWY NE BLDG 7",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300674061",
"telephone_number": "678-402-5235",
"fax_number": "770-818-5428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 VILLAGE PKWY NE BLDG 7",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30067",
"telephone_number": "678-402-5235",
"fax_number": "770-818-5428"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AMITY CARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-09-25",
"last_updated": "2018-07-26",
"status": "A",
"authorized_official_last_name": "GHADAMYARI",
"authorized_official_first_name": "AHMAD",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "678-402-5235"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "GA",
"license": "29670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.