Willowbrook Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

WILLOWBROOK HOSPICE LLC

Practice address

162 W Main St Ste 306
Cartersville, GA 30120-3573

Phone

(470) 315-4728

Fax

(470) 315-4844

NPI assigned

Sep 13, 2019

Organization subpart

No

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

Authorized official

Name

Stephanie Dubose

Title

Exec Director

Phone

(470) 315-4728

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Hospice certification: CCN 851535

Legal name

WILLOWBROOK HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 19, 2020

Last certification

Aug 19, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Enrollment address

162 W Main St
Ste 306
Cartersville, GA 30120-3573

Listed as

Willowbrook Hospice, LLCCCN 851535

Ownership

For-Profit

Certified

Aug 19, 2020

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 10

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shameka Hunt McElhaney, MD

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1144231598

  W-2 Managing Employee

  CMS ownership
• Punit Bhutwala, MD

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1316919384

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Christopher Sciacca, MPT

  • Physical Therapist
  • Fair Lawn, NJ
  • NPI 1003991852
  NPD

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Muhammad Mateen Akmal, M.D.

  • Family Medicine Physician
  • Ellijay, GA
  • NPI 1932269818

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1992355796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST STE 306",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203565",
            "telephone_number": "470-315-4728",
            "fax_number": "470-315-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 W MAIN ST STE 306",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301203573",
            "telephone_number": "470-315-4728",
            "fax_number": "470-315-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWBROOK HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-13",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "EXEC DIRECTOR",
        "authorized_official_telephone_number": "470-315-4728"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Watkins Williams, MD
• Tara Williams, CRNA
• Margaret Kennedy Williamson, RD
• Renee Willis, LPC, RPT, NCC
• Cheryl Griffin Willoughby, LPC
• Johnnie Willie Wilson III
• Sherry Lanette Wise-Mays
• Karen Patricia Wise, DDS
• Matthew Wiseman, DC
• Mackenzie B Wolfe, MSPT

• Community Based Hospice Care Agency in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Community Based Hospice Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.

Verify at the official NPI Registry.