Dignity Hospice of Southern West Virginia, Inc.
Organization Active NPI Community Based Hospice Care Agency · Chapmanville, WV
NPI 1992846307 · NPPES record last updated May 2, 2016
Key facts
- NPI
- 1992846307
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 2940195 (WV)
- Legal business name
- DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA, INC.
- Practice address
- 557 Main Street
Chapmanville, WV 25508 - Phone
- (304) 855-4764
- Fax
- (304) 831-6001
- NPI assigned
- Feb 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Drew W Lewis
- Title
- Chief Operating Officer
- Phone
- (304) 855-4764
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 2
Affiliated clinicians 43
-
Kenneth Adkins, DO
-
Rachel Sue Baisden, APRN
-
Dena Kay Barker, APRN, FNP-C
-
Jon R Bowen, MD
-
Andrew D Bryant, D.O
-
Sidney Jerome Cline, APRN
-
Martin L. Codispoti, FNP-BC
-
Sarah Ann Conn, APRN, FNP-BC
-
Amber Ellis, FNP-BC
-
Anitra Marie Ellis, NP-C
-
Kwasi Amponsah Gambrah, M.D.
-
Melanie Lea Harper-Allen, RN/NP
-
Jaime T Hayes, MD
-
Leevetta Lynn Holstein, APRN-FNP
-
Richard W Knapp, MD
-
Radhakrishna Kukkillaya, M.D.
-
Barbara Jean McNally, FNP
-
Amanda G Messer, FNP-BC
Medicare Care Compare: Home health agency
- Listed as
- Dignity Home Health
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Proprietary
- Certified
- Sep 19, 2007
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D2058177 | Dignity Hospice & Home Health | Certificate of waiver | Apr 30, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Home health agency certification: CCN 517134
- Legal name
- DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC
- Doing business as
- DIGNITY HOME HEALTH
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Sep 19, 2007
- Last certification
- Nov 13, 2019
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Non-profit
- Incorporated
- Mar 5, 1993 in WV
- Enrollment address
- 557 Main St
Chapmanville, WV 25508-4304
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Eddie Jo Canterbury |
Corporate Director |
Apr 1, 2021 | |
| Dennis R Lewis |
Corporate Director |
Apr 18, 2018 | |
| Susan P Gore |
Corporate Director |
Jan 1, 2005 | |
| Operational/Managerial Control |
Jan 5, 2005 | ||
| Nancy Godby |
Corporate Director |
Mar 1, 2003 | |
| Drew Lewis |
Corporate Officer |
Mar 16, 2010 | |
| Martha Thornhill |
Corporate Director |
Sep 23, 2014 | |
| Riley Jordan Evans |
Corporate Director |
Apr 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070313000118 | WV | Part a Provider - Home Health Agency | 3779686118 | Practice locations: Chapmanville, WV |
National Provider Directory
- Tax ID family
- Dignity Hospice of Southern
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 041729 | WV | |
| Community Based Hospice Care Agency | 251G00000X | 2940195 | WV | Yes |
Addresses
Primary practice location
557 Main Street
Chapmanville, WV 25508
Mailing address
P.O. Box 4304
Chapmanville, WV 25508
Phone (304) 855-4764
Other names
- Dignity Home Health
Other providers in Chapmanville, WV
- Caine Thomas Dials
- Dignity Hospice O Southern WV
- Dignity Hospice of Southern West Virginia Inc
- Dignity Hospice of Southern West Virginia Inc.
- Dignity Hospice of Southern West Virginia Inc.
- Casie Marie Dillon
- Leslie Dillon
- Ella Dingess
- Tasha Kay Dingess
- Lisa Lynn Dodge
All providers in Chapmanville, WV · Community Based Hospice Care Agency in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.