Active NPI
Heart to Heart Hospice of Northwest Indiana LLC
- Community Based Hospice Care Agency
- Valparaiso, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- HEART TO HEART HOSPICE OF NORTHWEST INDIANA LLC
- Practice address
- 402 Wall St Ste 51
Valparaiso, IN 46383-2567 - Phone
- (219) 252-4860
- Fax
- (219) 895-2301
- NPI assigned
- Sep 5, 2019
- Last updated
- May 5, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kelly O Mitchell
- Title
- Manager
- Phone
- (972) 517-6300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
402 Wall St Ste 51
Valparaiso, IN 46383-2567
Mailing address
7240 Chase Oaks Blvd
Plano, TX 75025-5901
Phone (972) 517-6300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1023667755. Details of each certification follow.
Hospice certification: CCN 151632
- Legal name
- HEART TO HEART HOSPICE OF NORTHWEST INDIANA, LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jun 25, 2020
- Last certification
- Jun 25, 2020
- Ownership / control type
- Proprietary - Other
- Organization structure
- LLC
- Incorporated
- Sep 3, 2019 in IN
- Enrollment address
- 402 Wall St
Ste 12
Valparaiso, IN 46383-2567
Care Compare: Hospice
Medicare Care Compare- Listed as
- Heart to Heart Hospice of Northwest Indiana, LLC
- Ownership
- For-Profit
- Certified
- Jun 25, 2020
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2173837 | Heart to Heart Hospice of Northwest Indiana, LLC | Certificate of waiver | Oct 20, 2027 |
National Provider Directory
National Provider DirectoryLocations
9111 Broadway
Ste Cc
Merrillville, IN 46410
Phone (219) 713-0653
402 Wall St
Ste 12
Valparaiso, IN 46383
Phone (219) 252-4860
402 Wall St
Ste 51
Valparaiso, IN 46383
Phone (219) 252-4860
Ownership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Indiana Hospice DFW, LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 6.25% |
| Heart to Heart Indiana Holdco, LLC | 5% Or Greater Direct Ownership Interest | Sep 3, 2019 | 100% |
| Courtney Fokianos | W-2 Managing Employee | Aug 10, 2022 | |
| Heart to Heart Hospice Holdings LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 100% |
| Indiana Hospice DFW Two, LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 6.25% |
| H to H Founders, LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 59.83% |
| Htohh Preferred LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 39.92% |
| Nadeem Kamran | Contracted Managing Employee | May 5, 2022 | |
| Indiana Medical Couriers and Express Delivery Services, LLC | 5% Or Greater Indirect Ownership Interest | Sep 3, 2019 | 87.5% |
| Kelly Mitchell | Corporate Officer | Sep 3, 2019 | |
| W-2 Managing Employee | Sep 3, 2019 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- La Porte, IN
- NPI 1275696171
Contracted Managing Employee
Facilities with the same owner 40
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba New Hope Hospice
- Community Based Hospice Care Agency
- Marion, IN
- NPI 1932104247
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
dba Heart to Heart Hospice of the River
- Community Based Hospice Care Agency
- Elkhart, IN
- NPI 1841821741
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Evansville, IN
- NPI 1588213425
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Indianapolis, IN
- NPI 1497976393
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Fort Wayne, IN
- NPI 1881243509
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Mishawaka, IN
- NPI 1295049724
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Jasper, IN
- NPI 1962585430
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
- Community Based Hospice Care Agency
- Terre Haute, IN
- NPI 1851729909
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Heart to Heart Indiana Holdco, LLC, Htohh Preferred LLC, Indiana Hospice DFW Two, LLC, Indiana Hospice DFW, LLC, Indiana Medical Couriers and Express Delivery Services, LLC
-
dba Heart to Heart Hospice of East Michigan
- Community Based Hospice Care Agency
- Chesterfield Township, MI
- NPI 1952875080
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Htohh Preferred LLC
-
dba Heart to Heart Hospice Inpatient Center
- Community Based Hospice Care Agency
- Fort Worth, TX
- NPI 1306351556
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Htohh Preferred LLC
-
dba Heart to Heart Hospice of Sugar Land
- Community Based Hospice Care Agency
- Sugar Land, TX
- NPI 1982056644
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Htohh Preferred LLC
-
dba Heart to Heart Hospice of South Texas
- Community Based Hospice Care Agency
- Jourdanton, TX
- NPI 1851651376
H to H Founders, LLC, Heart to Heart Hospice Holdings LLC, Htohh Preferred LLC
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- La Porte, IN
- NPI 1275696171
Affiliated clinicians 2
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": "1567641600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1588636800000",
"number": "1023667755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7240 CHASE OAKS BLVD",
"city": "PLANO",
"state": "TX",
"postal_code": "750255901",
"telephone_number": "972-517-6300",
"fax_number": "972-517-6301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 WALL ST STE 51",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463832567",
"telephone_number": "219-252-4860",
"fax_number": "219-895-2301"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEART TO HEART HOSPICE OF NORTHWEST INDIANA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-09-05",
"last_updated": "2020-05-05",
"certification_date": "2020-05-05",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "KELLY",
"authorized_official_middle_name": "O",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "972-517-6300",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.