Bristol Hospice - Oklahoma, L.L.C.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRISTOL HOSPICE - OKLAHOMA, L.L.C.

Practice address

4005 NW Expressway Ste 500E
Oklahoma City, OK 73116-1691

Phone

(405) 839-7100

Fax

(405) 766-6748

NPI assigned

Mar 11, 2022

Organization subpart

Yes

Parent organization

BRISTOL HOSPICE, L.L.C.As reported in NPPES

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

Authorized official

Name

Alex E Mauricio

Title

President/Ceo

Phone

(801) 325-0175

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Hospice certification: CCN 371732

Legal name

BRISTOL HOSPICE - OKLAHOMA, L.L.C.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 1, 2022

Last certification

Dec 1, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jan 14, 2022 in OK

Enrollment address

4005 NW Expressway
Ste 500E
Oklahoma City, OK 73116-1691

Listed as

Bristol Hospice-Oklahoma, L.L.C.CCN 371732

Certified

Dec 1, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Part of

Bristol Hospice LLC

Locations

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

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

• Ronald Cable, DO

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1467430900

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 52

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

• Bristol Hospice - Bangor, LLC

  • Community Based Hospice Care Agency
  • Bangor, ME
  • NPI 1336916469

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Bend, L.L.C.

  • Community Based Hospice Care Agency
  • Bend, OR
  • NPI 1356916845

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Blue Bell, LLC

  • Community Based Hospice Care Agency
  • Plymouth Meeting, PA
  • NPI 1356118467

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - California, LLC

  • Community Based Hospice Care Agency
  • Merced, CA
  • NPI 1487603452

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Charleston, LLC

  • Community Based Hospice Care Agency
  • North Charleston, SC
  • NPI 1326866963

  Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Chicago, L.L.C.

  • Community Based Hospice Care Agency
  • Des Plaines, IL
  • NPI 1104548478

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Eugene, LLC

  • Community Based Hospice Care Agency
  • Springfield, OR
  • NPI 1568962033

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Georgia LLC

  • Community Based Hospice Care Agency
  • Atlanta, GA
  • NPI 1558663872

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Green Bay, L.L.C.

  • Community Based Hospice Care Agency
  • Green Bay, WI
  • NPI 1356928154

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Hawaii, LLC

  • Community Based Hospice Care Agency
  • Honolulu, HI
  • NPI 1811045594

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Inland Empire, LLC

  • Community Based Hospice Care Agency
  • Riverside, CA
  • NPI 1043683170

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership
• Bristol Hospice - Inland Valley, L.L.C.

  • Community Based Hospice Care Agency
  • Ontario, CA
  • NPI 1013318112

  Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ronald Cable, DO

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1467430900

  Family Medicine

  NPD (past)

Affiliated clinicians 6

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ronald Cable, DO

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1467430900

  Hospice

  Care Compare affiliation
• Charity Dawn Johnson, DO

  • Family Medicine Physician
  • Fort Gibson, OK
  • NPI 1730522129

  Hospice

  Care Compare affiliation
• Brandon King, D.O.

  • Family Medicine Physician
  • Gore, OK
  • NPI 1609173038

  Hospice

  Care Compare affiliation
• Wilson Gregory Knight II, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Tulsa, OK
  • NPI 1376833160

  Hospice

  Care Compare affiliation
• Carl Andrew Raczkowski, M.D.

  • Gastroenterology Physician
  • Oklahoma City, OK
  • NPI 1851375646

  Hospice

  Care Compare affiliation
• Maria Elizabeth Super, D.O.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1619310422

  Hospice

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709251200000",
    "number": "1043968852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-325-0175",
            "fax_number": "801-478-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 NW EXPRESSWAY STE 500E",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731161691",
            "telephone_number": "405-839-7100",
            "fax_number": "405-766-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPICE - OKLAHOMA, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
        "enumeration_date": "2022-03-11",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "801-325-0175"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Brinlee, M.D.
• Daesha Daleigh Brinson, B.A. PSYCHOLOGY
• Makenzie Marie Briscoe
• Sasha Briscoe
• Anita Ryne Brison
• Cecca Pascaline Britt
• Chanda E Britt, RSS
• Deanna Dale Britt, PT
• Kiara Denise Britt
• Matthew Joseph Britt, M.D.

• All providers in Oklahoma City, OK
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; 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.

Verify at the official NPI Registry.