Active NPI
Bethany Hospice and Palliative Care, LLC
- Community Based Hospice Care Agency
- Valdosta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 092-154-H
- 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, 2025
- 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
- Mr. Christopher Smith
- Title
- Ceo
- Phone
- (205) 949-0400
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000887994A | Medicaid | GA |
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 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
- LLC
- 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 Hospice
- Ownership
- For-Profit
- Certified
- Aug 8, 2000
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D1064969 | Bethany Hospice | Certificate of waiver | Feb 18, 2027 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Bethany Hospice Holdings LLC | 5% Or Greater Direct Ownership Interest | Dec 23, 2022 | 100% |
| Ray L Shrout | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 11.8% |
| LLR Equity Partners VI LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 35.6% |
| LLR VI LL-Ah LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 15.8% |
| LLR LP Co-Invest VI-Ah LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 9.5% |
| Affinity Hospice Intermediate Holdings LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 100% |
| Christopher Smith | Corporate Officer | Sep 29, 2025 | 100% |
| Fosh Holdings LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 11.8% |
| Dragonfly Finance Holdco LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 100% |
| Adam C Cruse | Corporate Officer | Jul 15, 2024 | 100% |
| Go IV Equalization (Eci) LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 9.4% |
| LLR VI-Ah LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 35.6% |
| Affinity Hospice Holdings, LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 100% |
| LLR Equity Partners International VI LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 15.8% |
| Affinity Hospice Ultimate Holdings LLC | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 100% |
| LLR Equity Partners VI Co-Invest LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 9.5% |
| Franklin Park Co-Investment Fund V LP | 5% Or Greater Indirect Ownership Interest | Dec 23, 2022 | 6.2% |
| Caron Renee Drake | W-2 Managing Employee | May 15, 2026 | 100% |
| Kirk -Conrod P Hewling | Contracted Managing Employee | Jul 1, 2024 | 100% |
Facilities with the same owner 11
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Affinity Hospice
- Community Based Hospice Care Agency
- Marietta, GA
- NPI 1235654039
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
dba Affinity Hospice
- Community Based Hospice Care Agency
- Claxton, GA
- NPI 1548501000
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Bethany Hospice Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equaliza
-
dba Affinity Hospice
- Community Based Hospice Care Agency
- Canton, GA
- NPI 1497061709
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
- Community Based Hospice Care Agency
- Stockbridge, GA
- NPI 1043632334
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
dba BridgeWay Hospice
- Community Based Hospice Care Agency
- Lawrenceville, GA
- NPI 1003273095
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
- Community Based Hospice Care Agency
- Athens, GA
- NPI 1396948790
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
dba Affinity Hospice
- Community Based Hospice Care Agency
- Birmingham, AL
- NPI 1962893347
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, LLR Equity Partners International VI LP, LLR
-
dba Affinity Hospice
- Community Based Hospice Care Agency
- White Hall, AR
- NPI 1932874757
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
- Community Based Hospice Care Agency
- Greenville, SC
- NPI 1700329455
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC
-
dba Elite Hospice
- Community Based Hospice Care Agency
- Bristol, VA
- NPI 1922571561
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, Go IV Equalization (Eci) LP, LLR Equity Part
-
- Community Based Hospice Care Agency
- Greenville, SC
- NPI 1649521048
Affinity Hospice Holdings, LLC, Affinity Hospice Intermediate Holdings LLC, Affinity Hospice Ultimate Holdings LLC, Dragonfly Finance Holdco LLC, Fosh Holdings LLC, Franklin Park Co-Investment Fund V LP, LLR Equity Partners International VI LP, LLR
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.
-
- Family Nurse Practitioner
- Valdosta, GA
- NPI 1962393744
-
- Nurse Practitioner
- Waycross, GA
- NPI 1295387751
-
- Family Medicine Physician
- Douglas, GA
- NPI 1285756163
-
- Family Nurse Practitioner
- Cairo, GA
- NPI 1255988424
-
- Primary Care Nurse Practitioner
- Douglas, GA
- NPI 1972667954
-
- Family Medicine Physician
- Quitman, GA
- NPI 1972545119
-
- Medical Physician Assistant
- Douglas, GA
- NPI 1871504654
-
- Internal Medicine Physician
- Douglas, GA
- NPI 1225021678
-
- Contractor
- Moultrie, GA
- NPI 1184656332
-
- Internal Medicine Physician
- Valdosta, GA
- NPI 1023005121
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; 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.