NPIMap

Organization Active NPI

Heartland Hospice Services LLC

Doing business as ProMedica Hospice (Indianapolis)

  • Community Based Hospice Care Agency
  • Indianapolis, IN
National Provider Identifier
1023061686
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
07-003154-1 Issued in IN
Legal business name
HEARTLAND HOSPICE SERVICES LLC
Doing business as
ProMedica Hospice (Indianapolis)
Practice address
931 E 86TH St
Suite 208
Indianapolis, IN 46240-1852
Phone
(317) 251-3012
Fax
(317) 251-3016
NPI assigned
May 17, 2006
Last updated
Jan 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 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 07-003154-1 IN Primary

Addresses

Primary practice location

931 E 86TH St
Suite 208
Indianapolis, IN 46240-1852

Mailing address

333 N Summit St
Attn: Dean Shipman
Toledo, OH 43604-2615
Phone (419) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
200142900(B)MedicaidIN

Other names 1

  • ProMedica Hospice (Indianapolis) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200625000097 IN Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Fort Wayne, IN; Indianapolis, IN; Marion, IN; Mishawaka, IN; Terre Haute, IN

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 1

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 Hospice (Indianapolis)CCN 151573, IN, NPI 1740989243

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642896000000",
    "number": "1023061686",
    "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": "436042615",
            "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": "931 E 86TH ST",
            "address_2": "SUITE 208",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401852",
            "telephone_number": "317-251-3012",
            "fax_number": "317-251-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "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": "IN",
            "license": "07-003154-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200142900(B)",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Indianapolis)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.