MT BERRY HOSPICE INC. (NPI# 1306276498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306276498 |
| Entity Type | Organization |
| Organization Name | MT BERRY HOSPICE INC. |
| Practice Address |
4300 Martha Berry Hwy Ne Rome GA 30165-8642 |
| Practice Telephone | 7062321571 |
| Practice Fax Number | 7062321572 |
| Mailing Telephone | 7062321571 |
| Mailing Fax Number | 7062321572 |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2013-11-26 |
| Authorized Official Name | GEORGE WEST (CFO) |
| Authorized Official Telephone | 7709077222 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315D00000X | Hospice, Inpatient | 036-0347-H | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE PTAN | 11-1714 | 01 |
| Street Address |
4300 MARTHA BERRY HWY NE |
| City | ROME |
| State | GA |
| Zip Code | 30165-8642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578190450 | Four-sixty Inc | Counselor | 4300 Martha Berry Hwy Ne, Rome, GA 30165-8642 | 2020-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
| Find all providers in zip 30165 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
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| 1912489741 | Sacred Journey Hospice, Inc. | Hospice, Inpatient | 4165 Old Milton Pkwy Ste 200, Alpharetta, GA 30005-4478 | 2018-08-29 |
| 1427548676 | Sacred Journey Hospice, Inc. | Hospice, Inpatient | 60 Oak Hill Blvd Ste 203, Newnan, GA 30265-2314 | 2018-05-14 |
| 1811448319 | Butterfly Gardens Hospice & Palliative Care | Hospice, Inpatient | 3112 Blackmon Court, Hephzibah, GA 30815 | 2016-10-19 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1104221209 | Arcadia Hospice, LLC | Hospice, Inpatient | 119 Canal St Ste 103, Pooler, GA 31322 | 2014-10-31 |
| 1467746875 | Healing Hands | Hospice, Inpatient | 2667 C St, Macon, GA 31206-8307 | 2011-06-02 |
| 1982882114 | Serenity Hospice Care LLC | Hospice, Inpatient | 1057 N Houston Rd, Warner Robins, GA 31093-1563 | 2008-02-11 |
| 1518088038 | St. David Hospice | Hospice, Inpatient | 6101 Brixworth Pl Ne, Atlanta, GA 30319-5327 | 2007-04-02 |
| 1306919683 | Sacred Journey Hospice, Inc. | Hospice, Inpatient | 138 Peach Dr, Mcdonough, GA 30253 | 2006-11-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.