GUARDIAN ANGEL HOSPICE, INC — NPI 1053456459 (Licensed & Credentialed Nursing & Custodial Care Facilities

CMS-1500 Box 24J / 33a • NPI

1053456459

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

315D00000X (CMS B4[14])

Licensed & Credentialed Nursing & Custodial Care Facilities — Hospice, Inpatient

Box 32 Service Location & ZIP+4

41 S HALL RD, MORTON, MS, 39117-8057

✓ 9-Digit EDI 837 ZIP+4 (39117-8057)

Practice Phone & Referral Fax

(601) 732-8473

Fax: (601) 732-8037

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1053456459 (GUARDIAN ANGEL HOSPICE, INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1053456459` (NPI-2 Organization / Facility)
Provider / Legal Name	GUARDIAN ANGEL HOSPICE, INC
Plain-English Specialty	Licensed & Credentialed Nursing & Custodial Care Facilities — Hospice, Inpatient NUCC Code: `315D00000X` (Hospice, Inpatient)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	41 S HALL RD, MORTON, MS, 39117-8057
Practice Telephone / Fax	Tel: (601) 732-8473 \| Fax: (601) 732-8037
Administrative Mailing Address	41 S HALL RD, MORTON, MS, 39117-8057
Enumeration & Last Sync	Enumerated: 2007-02-21 \| CMS Record Updated: 2007-12-28
Authorized Official	PAULETTE BUTLER (CEO)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

41 S HALL RD, MORTON, MS, 39117-8057

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Plain-English Taxonomy & CMS Crosswalk (315D00000X)

What Does Taxonomy Code 315D00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 315D00000X translates to:
"Licensed & Credentialed Nursing & Custodial Care Facilities — Hospice, Inpatient"

CMS-1500 Medicare Specialty Crosswalk: CMS Code B4[14] (Rehabilitation Agency)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Hospice, Inpatient for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (GUARDIAN ANGEL HOSPICE, INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`315D00000X` — Hospice, Inpatient Plain English: Licensed & Credentialed Nursing & Custodial Care Facilities — Hospice, Inpatient	State: MS \| License: `059` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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GUARDIAN ANGEL HOSPICE, INC (NPI #1053456459)