Organization Active NPI

Bethany Hospice and Palliative Care, LLC

  • Community Based Hospice Care Agency
  • Valdosta, GA
National Provider Identifier
1972709160
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
092-154-H Issued in GA
Legal business name
BETHANY HOSPICE AND PALLIATIVE CARE, LLC
Practice address
2700 N Oak St
Building B
Valdosta, GA 31602-1772
Phone
(229) 249-8687
Fax
(229) 249-9282
NPI assigned
Jun 25, 2007
Last updated
Nov 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Mr. Christopher Smith
Title
Ceo
Phone
(205) 949-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 092-154-H GA Primary
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 092-154-H GA

Addresses

Primary practice location

2700 N Oak St
Building B
Valdosta, GA 31602-1772

Mailing address

135 Gemini Cir Ste 202
Birmingham, AL 35209-5842
Phone (205) 949-0400

Other practice location 1

2016 E Pinetree BLVD
Thomasville, GA 31792
Phone (229) 236-3002

Other practice location 2

1327 Ocilla Rd
Douglas, GA 31533-2213
Phone (912) 384-6100

Other identifiers 1

IdentifierTypeStateIssuer
000887994AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071119000220 GA Part A Provider - Hospice 1052409414 Practice locations: Douglas, GA; Thomasville, GA; Valdosta, GA
O20170428001358 GA Part B Supplier - Clinic/Group Practice 1052409414 Receives reassigned benefits from 7 practitioners
Practice locations: Thomasville, GA; Valdosta, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972709160. Details of each certification follow.

Hospice certification: CCN 111587

Legal name
BETHANY HOSPICE AND PALLIATIVE CARE, LLC
Doing business as
AFFINITY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 8, 2000
Last certification
Jan 20, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jun 16, 2007 in GA
Enrollment address
2700 N Oak St
BLDG B
Valdosta, GA 31602-5903

Care Compare: Hospice

Medicare Care Compare
Listed as
Affinity HospiceCCN 111587 · All quality measures
Ownership
For-Profit
Certified
Aug 8, 2000
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D1064969Bethany Hospice2700 North Oak St, BLD B, Valdosta, GA 31602Certificate of waiverFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

135 Gemini Cir
Birmingham, AL 35209

101 Bowens Mill Rd
Ste E
Douglas, GA 31533
Phone (912) 384-6100

1327 Ocilla Rd
Douglas, GA 31533
Phone (912) 383-9987

1400 Peterson Ave N
Ste 12
Douglas, GA 31533
Phone (912) 384-6100

201 Westside Dr
Douglas, GA 31533
Phone (912) 384-6100

1321 S Main St
Moultrie, GA 31768
Phone (229) 873-3259

2012 E Pinetree Blvd
Ste A
Thomasville, GA 31792
Phone (229) 236-3002

2016 E Pinetree Blvd
Thomasville, GA 31792
Phone (229) 236-3002

2016E Pinetree Blvd
Thomasville, GA 31792
Phone (229) 249-8687

2517 Bemiss Rd
Ste D
Valdosta, GA 31602
Phone (229) 245-6591

2700 N Oak St
Bldg B
Valdosta, GA 31602
Phone (229) 219-7993

2700 N Oak St
Bldg N
Valdosta, GA 31602

2704 N Oak St
Bldg N
Valdosta, GA 31602
Phone (229) 242-8904

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Bethany Hospice Holdings LLC Organization, Birmingham, AL Created for acquisition, For-profit 5% Or Greater Direct Ownership Interest Dec 23, 2022 100%
Ray L Shrout Individual 5% Or Greater Indirect Ownership Interest Dec 23, 2022 11.8%
LLR Equity Partners VI LP Organization, Philadelphia, PA For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 35.6%
LLR VI LL-Ah LP Organization, Philadelphia, PA Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 15.8%
LLR LP Co-Invest VI-Ah LLC Organization, Philadelphia, PA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 9.5%
Affinity Hospice Intermediate Holdings LLC Organization, Birmingham, AL LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 100%
Christopher Smith Individual Corporate OfficerCeo Sep 29, 2025 100%
Fosh Holdings LLC Organization, Key Largo, FL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 11.8%
Dragonfly Finance Holdco LLC Organization, Birmingham, AL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 100%
Adam C Cruse Individual Corporate OfficerChief Financial Officer Jul 15, 2024 100%
Go IV Equalization (Eci) LP Organization, New York, NY 5% Or Greater Indirect Ownership Interest Dec 23, 2022 9.4%
LLR VI-Ah LLC Organization, Philadelphia, PA LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 35.6%
Affinity Hospice Holdings, LLC Organization, Birmingham, AL LLC, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 100%
LLR Equity Partners International VI LP Organization, Philadelphia, PA For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 15.8%
Affinity Hospice Ultimate Holdings LLC Organization, Birmingham, AL LLC, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 100%
LLR Equity Partners VI Co-Invest LP Organization, Philadelphia, PA For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 9.5%
Franklin Park Co-Investment Fund V LP Organization, Bala Cynwyd, PA Holding company, For-profit 5% Or Greater Indirect Ownership Interest Dec 23, 2022 6.2%
Caron Renee Drake Individual W-2 Managing EmployeeAd; May 15, 2026 100%
Kirk -Conrod P Hewling Individual Contracted Managing EmployeeMD; Jul 1, 2024 100%

Facilities with the same owner 11

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 3

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": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1972709160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GEMINI CIR STE 202",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352095842",
            "telephone_number": "205-949-0400",
            "fax_number": "205-949-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N OAK ST",
            "address_2": "BUILDING B",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021772",
            "telephone_number": "229-249-8687",
            "fax_number": "229-249-9282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2016 E Pinetree BLVD",
            "address_purpose": "LOCATION",
            "city": "Thomasville",
            "state": "GA",
            "postal_code": "31792",
            "country_code": "US",
            "telephone_number": "229-236-3002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1327 Ocilla Rd",
            "address_purpose": "LOCATION",
            "city": "Douglas",
            "state": "GA",
            "postal_code": "315332213",
            "country_code": "US",
            "telephone_number": "912-384-6100",
            "fax_number": "912-384-5701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BETHANY HOSPICE AND PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-25",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-949-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": "092-154-H",
            "primary": true
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "092-154-H",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000887994A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.