Public record

CMS Hospice All Owners

Associate id: 0244764751 · 16 matching records

Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
0941112973
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-05-01
First name - owner
WILFORD
Middle name - owner
ALBERT
Last name - owner
PAYNE
Title - owner
PRESIDENT/CEO OF MANAGER-MANAGED
Percentage ownership
50
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
1052772100
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-05-01
Organization name - owner
PAYNE CAMELLIA FAMILY TRUST
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
33.64
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
N
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
1254792302
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-05-01
Organization name - owner
PAYNE OPPORTUNITY FUND LLC
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
10.2
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
Y
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
1254832967
Type - owner
I
Role code - owner
42
Role text - owner
W-2 MANAGING EMPLOYEE
Association date - owner
2024-05-01
First name - owner
CHRISTY
Last name - owner
WOODS
Title - owner
AD;
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
1850203886
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2024-05-01
First name - owner
WILFORD
Middle name - owner
ALBERT
Last name - owner
PAYNE
Title - owner
PRESIDENT/CEO OF MANAGER-MANAGED
Percentage ownership
50
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
2264893312
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2024-06-01
Organization name - owner
ARDEN HOME HEALTH AND HOSPICE LLC
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
Y
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Owned by another org or ind - owner
Y
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
2769853068
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-05-01
First name - owner
PATRICIA
Last name - owner
PATTERSON
Title - owner
COO OF OPERATIONS
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
3274778964
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2024-05-01
First name - owner
DONNA
Middle name - owner
A
Last name - owner
SULLIVAN
Title - owner
CHIEF OPERATING OFFICER OF MAYFAIR
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
4587650254
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2024-05-01
First name - owner
KENNETH
Last name - owner
SALHANY
Title - owner
MD;
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
6507011004
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-05-01
Organization name - owner
WILFORD A PAYNE JR FAMILY TRUST U/A 6/2/2020
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
22.85
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
N
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
7315192812
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-05-01
Organization name - owner
WILFORD A PAYNE III CHILDRENS TR UA
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
56.52
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
N
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
7416318563
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-05-01
Organization name - owner
WILFORD A PAYNEJRGRANTOR TRUSTU/A 12/17/2020
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
15
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
Y
Other type text - owner
TRUST
Owned by another org or ind - owner
N
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
7810300431
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2024-05-01
First name - owner
ANTHONY
Middle name - owner
ALAN
Last name - owner
BLAKENEY
Title - owner
CHIEF FINANCIAL OFFICER OF MANAG
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
7911378971
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-05-01
Organization name - owner
MAYFAIR MANAGEMENT LLC
Address line 1 - owner
135 MAYFAIR ROAD
City - owner
HATTIESBURG
State - owner
MS
Zip code - owner
394021464
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
Y
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
N
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
8123289790
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2024-05-01
First name - owner
ANGELA
Last name - owner
REYNOLDS
Title - owner
DIRECTOR OF REVENUE CYCLE MAYFAIR M
Enrollment id
O20241106002461
Associate id
0244764751
Organization name
ARDEN HOSPICE OF SOUTHERN TENNESSEE, LLC
Associate id - owner
9335500495
Type - owner
I
Role code - owner
25
Role text - owner
CONTRACTED MANAGING EMPLOYEE
Association date - owner
2024-05-01
First name - owner
CHRISTIANA
Last name - owner
LEGETT
Title - owner
CONTROLLER MAYFAIR MANAGEMENT LLC

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