Organization Active NPI

In Home Health, LLC

Doing business as ProMedica Hospice (Kansas City)

  • Community Based Hospice Care Agency
  • Independence, MO
National Provider Identifier
1003840984
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
111-15HO Issued in MO
Legal business name
IN HOME HEALTH, LLC
Doing business as
ProMedica Hospice (Kansas City)
Practice address
4731 S Cochise Dr Ste 120
Independence, MO 64055-6975
Phone
(816) 943-1798
Fax
(816) 941-3881
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 111-15HO MO Primary

Addresses

Primary practice location

4731 S Cochise Dr Ste 120
Independence, MO 64055-6975

Mailing address

333 N Summit St
Attn Dean Shipman
Toledo, OH 43604-1531
Phone (419) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
828561100MedicaidMO

Other names 1

  • ProMedica Hospice (Kansas City) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the seller Heartland Hospice (Kansas City)CCN 261572, MO, NPI 1891494308

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1003840984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "ATTN DEAN SHIPMAN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4731 S COCHISE DR STE 120",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556975",
            "telephone_number": "816-943-1798",
            "fax_number": "816-941-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "111-15HO",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "828561100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Kansas City)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, MO

Sources for this page

Verify at the official NPI Registry.