Organization Active NPI

Heartland Hospice Services, LLC

Doing business as ProMedica Hospice (Ann Arbor)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Ann Arbor, MI
National Provider Identifier
1083356562
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Doing business as
ProMedica Hospice (Ann Arbor)
Practice address
3840 Packard St Ste 260
Ann Arbor, MI 48108-2283
Phone
(734) 973-1145
NPI assigned
Apr 13, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Mr. Martin David Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

3840 Packard St Ste 260
Ann Arbor, MI 48108-2283

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (194) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
2139343MedicaidMI

Other names 1

  • ProMedica Hospice (Ann Arbor) Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1083356562",
    "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": "194-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 PACKARD ST STE 260",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082283",
            "telephone_number": "734-973-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "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": "2139343",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Ann Arbor)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.