HARBOR GRACE HOSPICE, INC.
NPI 1205960473
Hospice Care, Community Based in Fayetteville, GA
NPI Status: Active since March 16, 2007
Contact Information
500 W LANIER AVE
SUITE 401
FAYETTEVILLE, GA
ZIP 30214
Phone: (678) 962-5850
Fax: (678) 962-5855
- Organization
- Hospice Care, Community Based
- Accepts Insurance
- CLIA Number: 11D1047460
- CLIA Cert. Type: Hospice
- CLIA Exp. Date: 11-06-2027
About HARBOR GRACE HOSPICE, INC.
This page provides the complete NPI Profile along with additional information for Harbor Grace Hospice, Inc., a provider established in Fayetteville, Georgia operating as a Hospice Care, Community Based. The healthcare provider is registered in the NPI registry with number 1205960473 assigned on March 2007. The practitioner's primary taxonomy code is 251G00000X with license number 056-242-H (GA). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Ms. Jodi Wrenn Rn, Chpn (Administrator)
- NPI
- 1205960473
- Provider Name
- HARBOR GRACE HOSPICE, INC.
- Entity Type
- Organization
- Location Address
- 500 W LANIER AVE SUITE 401 FAYETTEVILLE, GA 30214
- Location Phone
- (678) 962-5850
- Location Fax
- (678) 962-5855
- Mailing Address
- 500 W LANIER AVE SUITE 401 FAYETTEVILLE, GA 30214
- Mailing Phone
- (678) 962-5850
- Mailing Fax
- (678) 962-5855
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-16-2007
- Last Update Date
- 08-13-2009
- Code Navigator
According to the Hospice Quality Reporting Program (HQRP) data this facility is for-profit and was certified on 09-12-2005 This facility was recently evaluated on the following quality measures: average daily census, hospice served at least 1 patient with both medicare and medicaid coverage during one year, hospice served at least 1 patient enrolled in medicare advantage during one year, care provided in assisted living facility and care provided in home, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Hospice Care, Community Based
- Taxonomy Code
- 251G00000X
- Type
- Agencies
- License No.
- 056-242-H
- License State
- GA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Gold - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Clarity Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
- Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 111621 | MEDICARE ID-TYPE UNSPECIFIED (04) | GA | PROVIDER NUMBER |
Hospice Care Information
The Centers for Medicare and Medicaid Services Hospice Quality Reporting Program (HQRP) data provides information on the quality of care that hospice facilities are providing to their patients. The quality reporting data gives families and patients the information they need to decide which hospice is right for them.
| CMS Certification Number (CCN) | 111621 |
| Ownership Type | For-Profit |
| Medicare Certification Date | 09-12-2005 |
| Quality Measure | Measure Score |
|---|---|
| Average Daily Census Number of patients cared for by a hospice on average each day | 44.0 |
| Hospice served at least 1 patient with both Medicare and Medicaid coverage during one year 1= Hospice served at least 1 patient with both Medicaid and Medicare coverage OR 0 = Hospice did not serve any patients with both Medicaid and Medicare coverage | Yes |
| Hospice served at least 1 patient enrolled in Medicare Advantage during one year 1 = Hospice served at least one patient enrolled in Medicare Advantage OR 0 = Hospice did not serve any patients enrolled in Medicare Advantage | Yes |
| Care Provided in Assisted Living Facility Percentage of days patients received care in an assisted living facility | Not Available - Number of patients is too small to report. |
| Care Provided in Home Percentage of days patients received care in home | 82 |
| Care Provided in Inpatient Hospice Facility Percentage of days patients received care in an inpatient hospice | 14 |
| Care Provided in Inpatient Hospital Facility Percentage of days patients received care in an inpatient hospital | 2 |
| Care Provided in Nursing Facility Percentage of days patients received care in a nursing facility | Not Available - Number of patients is too small to report. |
| Care Provided in All other locations Percentage of days patients received care in other locations | Not Available - Number of patients is too small to report. |
| Care Provided in Skilled Nursing Facility Percentage of days patients received care in a skilled nursing facility | 0 - Value is based on one year of data and does not indicate that the hospice would have 0% in more recent years. |
| Hospice and Palliative Care Treatment Preferences Facility observed rate | 98.8 |
| Beliefs & Values Addressed (if desired by the patient) Facility observed rate | 98.8 |
| Hospice and Palliative Care Pain Screening Facility observed rate | 96.9 |
| Hospice and Palliative Care Pain Assessment Facility observed rate | 93.0 |
| Hospice and Palliative Care Dyspnea Screening Facility observed rate | 99.9 |
| Hospice and Palliative Care Dyspnea Treatment Facility observed rate | 99.5 |
| Patient Treated with an Opioid Who Are Given a Bowel Regimen Facility observed rate | 98.5 |
| Hospice and Palliative Care Composite Process Measure Facility observed rate | 91.9 |
| Hospice Visits in the Last Days of Life | 197 |
| Hospice Visits in the Last Days of Life Facility observed rate | 26.9 |
| Hospice Care Index Overall Score Facility observed rate | 9.0 |
| CHC/GIP provided (% days) | 25,342 |
| CHC/GIP provided (% days) Facility observed rate | 12.9 |
| CHC/GIP provided (% days) | 100 |
| Gaps in nursing visits (% elections) | 140 |
| Gaps in nursing visits (% elections) Facility observed rate | 81.4 |
| Gaps in nursing visits (% elections) | 87 |
| Early live discharges (% live discharges) | 46 |
| Early live discharges (% live discharges) Facility observed rate | 26.1 |
| Early live discharges (% live discharges) | 99 |
| Late live discharges (% live discharges) | 46 |
| Late live discharges (% live discharges) Facility observed rate | 15.2 |
| Late live discharges (% live discharges) | 6 |
| Burdensome transitions, Type 1(% live discharges) | 46 |
| Burdensome transitions, Type 1 (% live discharges) Facility observed rate | 10.9 |
| Burdensome transitions, Type 1 (% live discharges) | 71 |
| Burdensome transitions, Type 2(% live discharges) | 46 |
| Burdensome transitions, Type 2 (% live discharges) Facility observed rate | 4.3 |
| Burdensome transitions, Type 2 (% live discharges) | 86 |
| Per-beneficiary spending (U.S. dollars $) | 927 |
| Per-beneficiary spending (U.S. dollars $) Facility observed rate | 7,216 |
| Per-beneficiary spending (U.S. dollars $) | 4 |
| Nurse care minutes per routine home care days (minutes) | 22,082 |
| Nurse care minutes per routine home care days (minutes) Facility observed rate | 79.6 |
| Nurse care minutes per routine home care days (minutes) | 100 |
| Skilled nursing minutes on weekends (% minutes) | 1,757,700 |
| Skilled nursing minutes on weekends (% minutes) Facility observed rate | 19.1 |
| Skilled nursing minutes on weekends (% minutes) | 94 |
| Visits near death (% decedents) | 837 |
| Visits near death (% decedents) Facility observed rate | 91.4 |
| Visits near death (% decedents) | 39 |
| Percent of Patients with Cancer Percentage of patients at hospice who had Cancer as their primary diagnosis | 27 |
| Percent of Patients with Circulatory/heart disease Percentage of patients at hospice who had Circulatory Heart Disease as their primary diagnosis | 6 |
| Percent of Patients with Dementia Percentage of patients at hospice who had Dementia as their primary diagnosis | 7 |
| Percent of Patients with Other Conditions Percentage of patients at hospice who had some other conditions as their primary diagnosis | 12 |
| Percent of Patients with Respiratory disease Percentage of patients at hospice who had Respiratory Disease as their primary diagnosis | 2 |
| Percent of Patients with Stroke Percentage of patients at hospice who had Stroke as their primary diagnosis | 14 |
| Provided Routine Home Care and other levels of care Th hospice had at least one incidence of routine home care and at least one more incidence of care at another level. Blank: hospice only provided care at routine home care level | Yes |
| Provided Routine Home Care only The hospice had at least one incidence of RHC over the 3 years, and no incidences of care at any other level. Blank: the hospice had at least one incidence of care at another level | No |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D1047460
- Facility Type
- Hospice
- Certificate Effective Date
- November 07, 2025
- Certificate Expiration Date
- November 06, 2027
- Laboratory Director
- TOREY B. CLARK
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Harbor Grace Hospice, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1205960473, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
FAYETTEVILLE, GA 30214
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1205960473, enumerated as an "organization" on March 16, 2007.
The provider is located at 500 W LANIER AVE SUITE 401 FAYETTEVILLE, GA 30214 and the phone number is (678) 962-5850.
Hospice Care, Community Based with taxonomy code 251G00000X.
The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter. Please consult your insurance carrier or call the provider to verify.
