NPIMap

Organization Active NPI

Heartland Hospice Services LLC

  • Community Based Hospice Care Agency
  • Independence, OH
National Provider Identifier
1013968635
Registry record updated Nov 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0130HSP Issued in OH
Legal business name
HEARTLAND HOSPICE SERVICES LLC
Practice address
4807 Rockside Rd
Suite 110
Independence, OH 44131-2140
Phone
(216) 520-0765
Fax
(216) 520-1427
NPI assigned
May 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2022

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 0130HSP OH Primary

Addresses

Primary practice location

4807 Rockside Rd
Suite 110
Independence, OH 44131-2140

Mailing address

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

Other practice location 1

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

Other identifiers 1

IdentifierTypeStateIssuer
2207365MedicaidOH

Other names 1

  • ProMedica Hospice (Cleveland) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200623001943 OH Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 4 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Washington Court House, OH; Sidney, OH; Marion, OH; Lucasville, OH; Kettering, OH; Jackson, OH; Independence, OH…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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 HospiceCCN 361584, OH, NPI 1023717535

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": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1013968635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "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": "4807 ROCKSIDE RD",
            "address_2": "SUITE 110",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312140",
            "telephone_number": "216-520-0765",
            "fax_number": "216-520-1427"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Summit St",
            "address_2": "Attn: Dean Shipman",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436041531",
            "country_code": "US",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "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": "OH",
            "license": "0130HSP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207365",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Cleveland)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

Verify at the official NPI Registry.