NPIMap

Organization Active NPI

Hospice of Laughlin LLC

Doing business as Beacon of Hope Hospice

  • Community Based Hospice Care Agency
  • Laughlin, NV
National Provider Identifier
1043885908
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOSPICE OF LAUGHLIN LLC
Doing business as
Beacon of Hope Hospice
Practice address
3030 S Needles Hwy Ste 1400
Laughlin, NV 89029-0893
Phone
(314) 815-3500
NPI assigned
May 24, 2021
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Tracey Sulzberger, RN
Title
Compliance Director
Phone
(314) 815-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

3030 S Needles Hwy Ste 1400
Laughlin, NV 89029-0893

Mailing address

2191 Lemay Ferry Rd Ste 300
Saint Louis, MO 63125-2483
Phone (314) 815-3500

Other names 1

  • Beacon of Hope Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220406002240 NV Part A Provider - Hospice 2264828904 Practice locations: Laughlin, NV

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043885908. Details of each certification follow.

Hospice certification: CCN 291623

Legal name
HOSPICE OF LAUGHLIN LLC
Doing business as
BEACON OF HOPE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 6, 2022
Last certification
Aug 24, 2022
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Incorporated
Apr 13, 2021 in NV
Enrollment address
3030 S Needles Hwy
Ste 1400
Laughlin, NV 89029-0893

Care Compare: Hospice

Medicare Care Compare
Listed as
Beacon of Hope HospiceCCN 291623 · All quality measures
Certified
Sep 6, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3030 S Needles Hwy
Ste 1400
Laughlin, NV 89029
Phone (314) 815-3500

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Jamie Lynn Smith Individual Operational/Managerial ControlAdministrator Dec 22, 2021
Tracey Sulzberger Individual Corporate DirectorDirector of Compliance Apr 13, 2021
Kandy M Mecum Individual Corporate OfficerSecretary Apr 13, 2021
National Hospice Management, Inc Organization, Saint Louis, MO For-profit 5% Or Greater Direct Ownership Interest Apr 21, 2021 100%
William John Moriconi Individual Corporate OfficerPresident Apr 13, 2021
Khurram J Khan Individual Corporate DirectorMedical Director Jan 1, 2026

Owners & managing parties with NPI records 2

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1621814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1043885908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 LEMAY FERRY RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631252483",
            "telephone_number": "314-815-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 S NEEDLES HWY STE 1400",
            "city": "LAUGHLIN",
            "state": "NV",
            "postal_code": "890290893",
            "telephone_number": "314-815-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE OF LAUGHLIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-24",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "SULZBERGER",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_title_or_position": "COMPLIANCE DIRECTOR",
        "authorized_official_telephone_number": "314-815-3500",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon of Hope Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laughlin, NV

Sources for this page

Verify at the official NPI Registry.