NPIMap

Organization Active NPI

Fremont Health

Doing business as Fremont Health Hospice

  • Community Based Hospice Care Agency
  • Fremont, NE
National Provider Identifier
1083653828
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOSPICE 9 Issued in NE
Legal business name
FREMONT HEALTH
Doing business as
Fremont Health Hospice
Practice address
2400 N Lincoln Ave
Suite B
Fremont, NE 68025-2443
Phone
(402) 941-1699
Fax
(402) 941-1688
NPI assigned
Jun 6, 2006
Last updated
Nov 6, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
FREMONT HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Mr. Patrick M Booth
Title
President/Ceo
Phone
(402) 721-1610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOSPICE 9 NE Primary

Addresses

Primary practice location

2400 N Lincoln Ave
Suite B
Fremont, NE 68025-2443

Mailing address

450 E 23Rd St
Fremont, NE 68025-2387
Phone (402) 721-1610

Other names 1

  • Fremont Health Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Mem Hosp of Dodge Count

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Oct 1, 2018 Change of OwnershipThis provider was the seller Methodist Fremont Health HospiceCCN 281511, NE, NPI 1245719228

Change of ownership 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1083653828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252387",
            "telephone_number": "402-721-1610",
            "fax_number": "402-727-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 N LINCOLN AVE",
            "address_2": "SUITE B",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252443",
            "telephone_number": "402-941-1699",
            "fax_number": "402-941-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREMONT HEALTH",
        "enumeration_date": "2006-06-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "402-721-1610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE 9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fremont Health Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, NE

Sources for this page

Verify at the official NPI Registry.