NPIMap

Organization Active NPI

Dignity Hospice of Southern West Virginia, Inc.

  • Community Based Hospice Care Agency
  • Chapmanville, WV
National Provider Identifier
1992846307
Registry record updated May 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2940195 Issued in 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
Last updated
May 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2016

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

Authorized official

Name
Mr. Drew W Lewis
Title
Chief Operating Officer
Phone
(304) 855-4764

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 041729 WV
Community Based Hospice Care Agency 251G00000X 2940195 WV Primary

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 1

  • Dignity Home Health Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070313000118 WV Part A Provider - Home Health Agency 3779686118 Practice locations: Chapmanville, WV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992846307. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Mar 5, 1993 in WV
Enrollment address
557 Main St
Chapmanville, WV 25508-4304

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Dignity Home HealthCCN 517134 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Sep 19, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
51D2058177Dignity Hospice & Home Health557 Main Street, Chapmanville, WV 25508Certificate of waiverApr 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Dignity Hospice of Southern3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Eddie Jo Canterbury Individual Corporate DirectorBoard Member Apr 1, 2021
Dennis R Lewis Individual Corporate DirectorPresident of Board Apr 18, 2018
Susan P Gore Individual Corporate DirectorBoard Secretary Jan 1, 2005
Operational/Managerial ControlBoard Secretary Jan 5, 2005
Nancy Godby Individual Corporate DirectorBoard Member Mar 1, 2003
Drew Lewis Individual Corporate OfficerChief Operating Officer Mar 16, 2010
Martha Thornhill Individual Corporate DirectorBoard Member Sep 23, 2014
Riley Jordan Evans Individual Corporate DirectorBoard Member Apr 1, 2021

Practitioners & affiliated clinicians

Affiliated clinicians 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462147200000",
    "number": "1992846307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4304",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "25508",
            "telephone_number": "304-855-4764",
            "fax_number": "304-831-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 MAIN STREET",
            "city": "CHAPMANVILLE",
            "state": "WV",
            "postal_code": "25508",
            "telephone_number": "304-855-4764",
            "fax_number": "304-831-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2016-05-02",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "304-855-4764",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WV",
            "license": "041729",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WV",
            "license": "2940195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dignity Home Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chapmanville, WV

Sources for this page

Verify at the official NPI Registry.