NPIMap

Organization Active NPI

Hospice & Palliative Care of the Ohio Valley, Inc

Doing business as Hospice of Western Kentucky

  • Community Based Hospice Care Agency
  • Owensboro, KY
National Provider Identifier
1003892977
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
400005 Issued in KY
Legal business name
HOSPICE & PALLIATIVE CARE OF THE OHIO VALLEY, INC
Doing business as
Hospice of Western Kentucky
Practice address
3419 Wathens Xing
Owensboro, KY 42301-7009
Phone
(270) 926-7565
Fax
(270) 685-0516
NPI assigned
Dec 21, 2005
Last updated
Jan 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Ms. Belinda Blair
Title
Chief Executive Officer
Phone
(270) 926-7565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 400005 KY Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

3419 Wathens Xing
Owensboro, KY 42301-7009

Mailing address

3419 Wathens Xing
Owensboro, KY 42301-7009
Phone (270) 926-7565

Other identifiers 1

IdentifierTypeStateIssuer
44030013MedicaidKY

Other names 1

  • Hospice of Western Kentucky Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20091021000614 KY Part A Provider - Hospice 2769529825 Practice locations: Owensboro, KY
O20170822003987 KY Part B Supplier - Clinic/Group Practice 2769529825 Receives reassigned benefits from 5 practitioners
Practice locations: Owensboro, KY

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003892977. Details of each certification follow.

Hospice certification: CCN 181520

Legal name
HOSPICE & PALLIATIVE CARE OF THE OHIO VALLEY, INC
Doing business as
HOSPICE OF WESTERN KENTUCKY
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 25, 1990
Last certification
Feb 15, 2018
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Jul 15, 1980 in KY
Enrollment address
3419 Wathens Xing
Owensboro, KY 42301-7009

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice of Western KentuckyCCN 181520 · All quality measures
Ownership
For-Profit
Certified
Apr 25, 1990
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3419 Wathens Xing
Owensboro, KY 42301
Phone (270) 313-8426

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Brenda Knollenberg Individual W-2 Managing EmployeeAdministrator Nov 3, 2020
Blake Edge Individual Corporate Director Jan 1, 2020
Hospice & Palliative Care of the Ohio Valley, Inc Organization, Owensboro, KY Corporation, Non-profit Operational/Managerial Control Oct 21, 2009
Mark McAnulty Individual Corporate Director Jan 1, 2020
Joni Sims Individual Corporate Director Jan 1, 2022
Neel Ford Individual Corporate DirectorBoard Member Jan 1, 2016
Alison McFarland Individual Corporate Director Jan 1, 2022
Beth Davis Individual Corporate Director Jan 1, 2020
Ryan Moore Individual Corporate Director Jan 1, 2020
Pamela L Smith-Wright Individual Corporate Director Jan 1, 2020
Michael Kelley Individual Corporate Director Jan 1, 2021
Carol Boling Individual Corporate Director Jan 1, 2020
Elizabeth Mahoney Individual Corporate Director Oct 21, 2009
W-2 Managing Employee Oct 21, 2009
Russ Lewis Individual Corporate Director Jan 1, 2021

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1003892977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 WATHENS XING",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017009",
            "telephone_number": "270-926-7565",
            "fax_number": "270-685-0516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 WATHENS XING",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017009",
            "telephone_number": "270-926-7565",
            "fax_number": "270-685-0516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE & PALLIATIVE CARE OF THE OHIO VALLEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "270-926-7565",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KY",
            "license": "400005",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44030013",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice of Western Kentucky",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hospice of Western Kentucky",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.