Active NPI
Heartland Hospice Services, LLC
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Simpsonville, SC
National Provider Identifier
1043959331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Legal business name
- HEARTLAND HOSPICE SERVICES, LLC
- Practice address
- 421 SE Main St Ste 100
Simpsonville, SC 29681-2697 - Phone
- (864) 963-0045
- NPI assigned
- Jun 3, 2022
- 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
- Martin David Allen
- Title
- Director
- Phone
- (419) 252-5734
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Internal Medicine) Physician | 207RH0002X | Primary |
Addresses
Primary practice location
421 SE Main St Ste 100
Simpsonville, SC 29681-2697
Mailing address
333 N Summit St
Toledo, OH 43604-1531
Phone (567) 585-1191
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HSP067 | Medicaid | SC |
Other names 1
- ProMedica Hospice (Greenville)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200619000235 | SC | Part B Supplier - Clinic/Group Practice | 4789592536 |
Receives reassigned benefits from 7 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Charleston, SC; Myrtle Beach, SC; Simpsonville, SC |
Other NPIs on the same Medicare enrollment 5
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community Based Hospice Care Agency
- Myrtle Beach, SC
- NPI 1457380586
O20200619000235
-
- Community Based Hospice Care Agency
- Simpsonville, SC
- NPI 1619906757
O20200619000235
-
- Community Based Hospice Care Agency
- Charleston, SC
- NPI 1013946144
O20200619000235
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Myrtle Beach, SC
- NPI 1144965971
O20200619000235
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- North Charleston, SC
- NPI 1174268965
O20200619000235
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
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 |
|---|---|---|---|
| Terrence G Metzger | Corporate Officer | Nov 1, 2023 | |
| Martin D Allen | Corporate Director | Sep 30, 2012 | |
| Operational/Managerial Control | Sep 22, 2007 | ||
| HCR Manor Care Services LLC | Operational/Managerial Control | Dec 21, 2007 | |
| HCR Healthcare, LLC | 5% Or Greater Indirect Ownership Interest | Dec 21, 2007 | 100% |
| Dean Shipman | W-2 Managing Employee | May 1, 2016 | |
| Terri Pomeroy | Contracted Managing Employee | Mar 4, 2013 | |
| Kathryn H Hoops | Corporate Officer | Nov 7, 2007 | |
| Stephen M Sadowski | Corporate Officer | Nov 1, 2023 | |
| Justin Skiver | Corporate Officer | Aug 29, 2023 | |
| Andrea Sype | Corporate Officer | Jan 1, 2021 | |
| HCR Manorcare, Inc. | 5% Or Greater Indirect Ownership Interest | Jul 26, 2018 | 100% |
| HCR Home Health Care and Hospice LLC | 5% Or Greater Direct Ownership Interest | Dec 21, 2007 | 100% |
| Eric J Talbert | Corporate Officer | Jun 24, 2013 | |
| Promedica Health System Inc | 5% Or Greater Indirect Ownership Interest | Jul 26, 2018 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654214400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1654214400000",
"number": "1043959331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 N SUMMIT ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436041531",
"telephone_number": "567-585-1191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 SE MAIN ST STE 100",
"city": "SIMPSONVILLE",
"state": "SC",
"postal_code": "296812697",
"telephone_number": "864-963-0045"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-06-03",
"last_updated": "2022-06-03",
"certification_date": "2022-06-03",
"status": "A",
"authorized_official_last_name": "ALLEN",
"authorized_official_first_name": "MARTIN",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "419-252-5734"
},
"taxonomies": [
{
"code": "207RH0002X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hospice and Palliative Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "HSP067",
"state": "SC"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "ProMedica Hospice (Greenville)",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Simpsonville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.