NPIMap

Organization Active NPI

Shalom Hospice LLC

  • Community Based Hospice Care Agency
  • Brentwood, TN
National Provider Identifier
1023756285
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SHALOM HOSPICE LLC
Practice address
5409 Maryland Way Ste 212
Brentwood, TN 37027-5068
Phone
(510) 499-9977
NPI assigned
May 26, 2022
Last updated
Jun 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Authorized official

Name
Samuel Stern
Title
Ceo
Phone
(510) 499-9977

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

5409 Maryland Way Ste 212
Brentwood, TN 37027-5068

Mailing address

5409 Maryland Way Ste 212
Brentwood, TN 37027-5068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230120000418 TN Part A Provider - Hospice 4981075496 Practice locations: Brentwood, TN
O20251009004494 TN Part B Supplier - Clinic/Group Practice 4981075496 Receives reassigned benefits from 4 practitioners
Practice locations: Brentwood, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023756285. Details of each certification follow.

Hospice certification: CCN 441606

Legal name
SHALOM HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 3, 2023
Last certification
Feb 3, 2023
Organization structure
LLCProprietary
Incorporated
Jan 21, 2022 in TN
Enrollment address
5409 Maryland Way
Ste 212
Brentwood, TN 37027-5068

Care Compare: Hospice

Medicare Care Compare
Listed as
Shalom Hospice, LLCCCN 441606 · All quality measures
Certified
Feb 3, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D2268647Shalom Hospice LLC5409 Maryland Way, Suite 212, Brentwood, TN 37027Certificate of waiverSep 14, 2026

National Provider Directory

National Provider Directory

Locations

5409 Maryland Way
Ste 212
Brentwood, TN 37027
Phone (615) 623-8900

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Starco Management LLC Organization, Brooklyn, NY LLC, Holding company 5% Or Greater Direct Ownership Interest Feb 8, 2026 100%
Donald Vollmer Individual W-2 Managing EmployeeMD; Sep 8, 2023
Samuel Stern Individual 5% Or Greater Indirect Ownership Interest Feb 8, 2026 90%
Corporate OfficerMember Jan 21, 2022
Corporate DirectorMember Jan 21, 2022
W-2 Managing EmployeeCeo Jan 21, 2022
Operational/Managerial ControlCeo Jan 21, 2022
Stern Family 2019 Trust Organization, Brooklyn, NY 5% Or Greater Indirect Ownership Interest Feb 8, 2026 10%
Veronica Roeder Individual W-2 Managing EmployeeHospice Administrator Oct 21, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

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.

Affiliated clinicians 10

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": "1653523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780963200000",
    "number": "1023756285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 MARYLAND WAY STE 212",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 MARYLAND WAY STE 212",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275068",
            "telephone_number": "510-499-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-26",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "510-499-9977"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, TN

Sources for this page

Verify at the official NPI Registry.