NPIMap

Organization Active NPI

A Path of Care Hospice IV, LLC

Doing business as A Path of Care Hospice

  • Community Based Hospice Care Agency
  • Lawton, OK
National Provider Identifier
1043905722
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
A PATH OF CARE HOSPICE IV, LLC
Doing business as
A Path of Care Hospice
Practice address
6202 NW Oak Ave
Lawton, OK 73505-4323
Phone
(580) 492-6166
Fax
(580) 492-6160
NPI assigned
Apr 7, 2023
Last updated
Mar 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
John Kelly
Title
Managing Member
Phone
(405) 928-2727

Specialties & licenses 1

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

Addresses

Primary practice location

6202 NW Oak Ave
Lawton, OK 73505-4323

Mailing address

2910 Adams Rd Ste 110
Norman, OK 73069-1023
Phone (405) 928-2727

Other identifiers 1

IdentifierTypeStateIssuer
4182OtherOKSTATE LICENSE

Other names 1

  • A Path of Care Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231213003439 OK Part A Provider - Hospice 7618326836 Practice locations: Lawton, OK; Marlow, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043905722. Details of each certification follow.

Hospice certification: CCN 371640

Legal name
A PATH OF CARE HOSPICE IV LLC
Doing business as
A PATH OF CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 11, 2004
Last certification
Sep 29, 2020
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Mar 27, 2023 in OK
Enrollment address
102 SW 3Rd St
Ste a
Lawton, OK 73501

Care Compare: Hospice

Medicare Care Compare
Listed as
A Path of Care Hospice IV, LLCCCN 371640 · All quality measures
Ownership
For-Profit
Certified
Aug 11, 2004
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
37D2300418A Path of Care Hospice IV, LLC102 SW 3Rd St, Ste a, Lawton, OK 73501Certificate of waiverMar 10, 2028

National Provider Directory

National Provider Directory

Locations

6202 NW Oak Ave
Lawton, OK 73505
Phone (580) 248-7400

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Home Health Holdings LLP Organization, Norman, OK Created for acquisition, Holding company 5% Or Greater Direct Ownership Interest Jul 31, 2023 80%
Gold Leaf Investments LLC Organization, Norman, OK LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 21, 2023 20%
John Kelly Individual Corporate OfficerManaging Member of LLC Jul 21, 2023 100%
Operational/Managerial ControlManaging Member of LLC Jul 21, 2023 100%

Facilities with the same owner 6

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

Change-of-ownership history 1

DateEventCounterparty
Jul 31, 2023 Change of OwnershipThis provider was the buyer Victory Home Health & HospiceCCN 371640, OK, NPI 1821076506

Change of ownership 1

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

Practitioners & affiliated clinicians

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": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1043905722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 ADAMS RD STE 110",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730691023",
            "telephone_number": "405-928-2727",
            "fax_number": "405-928-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6202 NW OAK AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054323",
            "telephone_number": "580-492-6166",
            "fax_number": "580-492-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A PATH OF CARE HOSPICE IV, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "405-928-2727"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "4182",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Path of Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.