CANON HOSPICE LLC (NPI# 1275632762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275632762 |
| Entity Type | Organization |
| Organization Name | CANON HOSPICE LLC |
| Practice Address |
13702 Coursey Blvd Ste 6a Baton Rouge LA 70817-1370 |
| Practice Telephone | 2259261404 |
| Practice Fax Number | 2259261403 |
| Mailing Telephone | 2259261404 |
| Mailing Fax Number | 2259261403 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-07-24 |
| Authorized Official Name | SHIVA K AKULA (OWNER) |
| Authorized Official Telephone | 5048182723 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315D00000X | Hospice, Inpatient | 149 | LA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1501054 | 05 |
| Street Address |
13702 COURSEY BLVD STE 6A |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70817-1370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
| 1457821043 | Traci Bellazin | Case Manager/Care Coordinator | 9334 Falling Oak Dr., Baton Rouge, LA 70817 | 2018-11-27 |
| 1124502869 | Jacob Schrieffer | Nurse Practitioner | 15389 Airline Highway, Baton Rouge, LA 70817 | 2018-09-19 |
| 1629564638 | Baton Rouge Dental Associates, LLC | Dentist | 14948 Market St, Baton Rouge, LA 70817 | 2018-07-03 |
| 1740786946 | Charlotte L Watts | Nurse Practitioner | 15389 Airline Hwy, Baton Rouge, LA 70817 | 2018-04-05 |
| 1164957536 | Deranecha Francois | Counselor | 17232 Jefferson Hwy, Apt 121, Baton Rouge, LA 70817 | 2017-04-24 |
| 1992251573 | Jacob Dent, Dds. Baton Rouge Modern Dentistry, A Professional Corp | Dentist | 14640 Village Market St, Suite 103, Baton Rouge, LA 70817 | 2016-09-01 |
| 1235522962 | Cardinal Community Services LLC | Clinic/Center | 13702 Coursey Blvd. Bldg 6 Ste A 2, Baton Rouge, LA 70817 | 2015-03-05 |
| 1962832204 | Bcbr Facility Services, LLC | Clinic/Center | 277 Rue De La Vie, Baton Rouge, LA 70817 | 2013-11-23 |
| 1700225737 | Renee Denise Beyer Boudreaux | Nurse Practitioner | 500 Rue De La Vie, Suite 401, Baton Rouge, LA 70817 | 2013-06-24 |
| Find all providers in zip 70817 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275818965 | Serenity Hospice Home, Inc | Hospice, Inpatient | 72 King Richard Rd, Dry Prong, LA 71423-8705 | 2011-10-13 |
| 1356644702 | Paramount Hospice North LLC | Hospice, Inpatient | 813 Pine St, West Monroe, LA 71291-4046 | 2010-12-07 |
| 1598987455 | Agape Hospice Care of Ruston, LLC | Hospice, Inpatient | 1503 Goodwin Rd, Suite 101, Ruston, LA 71270-2948 | 2007-05-02 |
| 1225079643 | Gamble Hospice Care Northwest, LLC | Hospice, Inpatient | 8950 E Kings Hwy, Shreveport, LA 71115 | 2006-06-09 |
| 1871563320 | Christus Continuing Care | Hospice, Inpatient | 4801 Jackson Street Ext, Suite B, Alexandria, LA 71303-2508 | 2006-01-26 |
| 1568699171 | Christus Continuing Care | Hospice, Inpatient | 1700 Buckner St, Suite 200, Shreveport, LA 71101-4452 | 2009-06-22 |
| 1912081217 | Community Care Hospice LLC | Hospice, Inpatient | 1007 W Thomas St, Suite A, Hammond, LA 70401-3062 | 2006-10-24 |
| 1598864084 | Canon Health Care LLC-tlhc | Hospice, Inpatient | 1221 S Clearview Pkwy, 4th Fl, Jefferson, LA 70121-1011 | 2006-09-21 |
| 1811923634 | Christus Health Northern Louisiana | Hospice, Inpatient | 1 Saint Mary Pl, Shreveport, LA 71101-4343 | 2006-06-23 |
| City | BATON ROUGE |
| Zip Code | 70817 |
Please comment or provide details below to improve the information on CANON HOSPICE LLC.
| 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.