NPIMap

Organization Active NPI

Fairhope Hospice & Palliative Care Inc

  • Community Based Hospice Care Agency
  • Lancaster, OH
National Provider Identifier
1003845298
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
FAIRHOPE HOSPICE & PALLIATIVE CARE INC
Practice address
282 Sells Road
Lancaster, OH 43130-4056
Phone
(740) 654-7077
Fax
(740) 654-0376
NPI assigned
Jul 1, 2006
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Ms. Kristin R Glasure, LSW
Title
Ceo
Phone
(740) 654-7077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

282 Sells Road
Lancaster, OH 43130-4056

Mailing address

282 Sells Rd
Lancaster, OH 43130-3461
Phone (740) 654-7077

Other identifiers 1

IdentifierTypeStateIssuer
0820160MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090528000332 OH Part A Provider - Hospice 0547319253 Practice locations: Lancaster, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003845298. Details of each certification follow.

Hospice certification: CCN 361504

Legal name
FAIRHOPE HOSPICE & PALLIATIVE CARE INC
Doing business as
FAIRHOPE HOSPICE & PALLIATIVE CARE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 11, 1984
Last certification
Apr 1, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
OtherNon-profit
Incorporated
Jan 12, 1984 in OH
Enrollment address
282 Sells Rd
Lancaster, OH 43130-3461

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Fairhope Hospice & Palliative Care, IncCCN 361504 · All quality measures
Ownership
For-Profit
Certified
Dec 11, 1984
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Fairhope Hospice Palliativ2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

282 Sells Rd
Lancaster, OH 43130
Phone (740) 654-7077

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Charles Barrows Individual Corporate OfficerBoard of Trustees, Vice President Jan 1, 2024
Fairhope Hospice & Palliative Care Inc Organization, Lancaster, OH Created for acquisition, Non-profit 5% Or Greater Direct Ownership Interest Jan 12, 1984 100%
Rachel Schlarb Individual Corporate OfficerBoard of Trustees Jan 1, 2024
Jennifer K Saffell Individual Corporate OfficerBoard of Trustees Jan 1, 2024
Matthew J Shaw Individual Corporate OfficerBoard of Trustees Jan 1, 2024
Marjorie Moore Individual Corporate OfficerSecretary, Board of Trustees Mar 14, 2019
Marc Miller Individual Corporate OfficerBoard of Trustees Jan 1, 2024
Kristy K Fosnaugh Individual Corporate OfficerBoard Trustee Mar 16, 2022
Andrew Specht Individual Corporate OfficerTreasurer, Board of Trustees Jan 1, 2021
Nicholas Merrill Individual Corporate OfficerChief Financial Officer Jan 1, 2026
W-2 Managing EmployeeChief Financial Officer Jan 1, 2026
Anupreet Kaur Individual Corporate OfficerBoard of Trustees Jan 1, 2025
Leroy B Varney Individual W-2 Managing EmployeeMD; Jan 1, 2024
Seth White Individual W-2 Managing EmployeeAd;Vice President Oct 1, 2023
Operational/Managerial ControlVice President Oct 1, 2023
John Snider Individual Corporate OfficerBoard of Trustees Jan 1, 2026
Kristin Glasure Individual Corporate OfficerBoard Trustee Jul 16, 2021
Corporate Director Jul 16, 2021
W-2 Managing Employee Jul 16, 2021
Operational/Managerial ControlPresident & Ceo Jul 16, 2021

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

Affiliated clinicians 12

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1003845298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 SELLS RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303461",
            "telephone_number": "740-654-7077",
            "fax_number": "740-654-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 SELLS ROAD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431304056",
            "telephone_number": "740-654-7077",
            "fax_number": "740-654-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRHOPE HOSPICE & PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "GLASURE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-654-7077",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0820160",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.