Headwaters Hospice and Palliative Care, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

HEADWATERS HOSPICE AND PALLIATIVE CARE, LLC

Practice address

2625 Winne Ave Ste A1
Helena, MT 59601-4958

Phone

(406) 422-0114

Fax

(406) 324-9190

NPI assigned

Jul 13, 2023

Last updated

Apr 6, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kris Miller

Title

Owner/President

Phone

(406) 465-0507

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013696442. Details of each certification follow.

• CCN 271542 Hospice · Active · Details

Hospice certification: CCN 271542

Legal name

HEADWATERS HOSPICE AND PALLIATIVE CARE, LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 17, 2023

Last certification

Dec 7, 2023

Organization structure

LLCProprietary

Incorporated

Nov 3, 2022 in MT

Enrollment address

2625 Winne Ave
# A1
Helena, MT 59601-4958

Listed as

Headwaters Hospice and Palliative Care, LLCCCN 271542 · All quality measures

Certified

Dec 17, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

Practitioners 6

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.

• Karry Mikel Clos, LPN

  • Licensed Practical Nurse
  • Helena, MT
  • NPI 1356142574
  NPD (past)
• Jenifer Patricia Dodge, MD

  • Family Medicine Physician
  • Helena, MT
  • NPI 1295724292
  NPD (past)
• Jasmine Gagnon, NP-C

  • Family Nurse Practitioner
  • Frenchtown, MT
  • NPI 1437991577
  NPD (past)
• Richard McEwen, PA-C

  • Physician Assistant
  • Butte, MT
  • NPI 1548744295
  NPD (past)
• Carissa Taylor, NP

  • Family Nurse Practitioner
  • Helena, MT
  • NPI 1548659527
  NPD (past)
• Emily Yelenich, NP

  • Family Nurse Practitioner
  • Butte, MT
  • NPI 1447737523
  NPD (past)

Affiliated clinicians 2

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

• Jenifer Patricia Dodge, MD

  • Family Medicine Physician
  • Helena, MT
  • NPI 1295724292

  Hospice

  Care Compare affiliation
• Kiley B Kirksey, M.D.

  • Family Medicine Physician
  • Helena, MT
  • NPI 1083875629

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775433600000",
    "number": "1013696442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WINNE AVE STE A1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014958",
            "telephone_number": "406-422-0114",
            "fax_number": "406-324-9190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 WINNE AVE STE A1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014958",
            "telephone_number": "406-422-0114",
            "fax_number": "406-324-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADWATERS HOSPICE AND PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-13",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "406-465-0507"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evonne Hawe, LAC
• Michael S Hay, M.D.
• Jessica Jean Hayes-Cook, LCPC
• Donovan Kristopher Hayes, D.C.
• Kyle Hayter, OD
• Headwaters Palliative Services
• Healing Mountain Mental Health
• Health Care Service Corporation, a Mutual Legal Reserve Company
• Health Haus Mobile LLC (Health Haus Mobile)
• Hearing Solutions of Montana LLC (Hearing Solutions of Montana)

• Community Based Hospice Care Agency in Helena, MT
• Providers in Helena, MT by specialty
• Community Based Hospice Care Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.