NPIMap

Organization Active NPI

Mesa View Hospice, LLC

  • Community Based Hospice Care Agency
  • Mesquite, NV
National Provider Identifier
1134448475
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
NV20101297547 Issued in NV
Legal business name
MESA VIEW HOSPICE, LLC
Practice address
330 Falcon Ridge Pkwy
Building 200 Suite a
Mesquite, NV 89027-8877
Phone
(702) 346-3088
Fax
(702) 346-3086
NPI assigned
May 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Authorized official

Name
Mrs. Shannel Rowley, RN
Title
Administrator
Phone
(702) 346-3088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NV20101297547 NV Primary

Addresses

Primary practice location

330 Falcon Ridge Pkwy
Building 200 Suite a
Mesquite, NV 89027-8877

Mailing address

330 Falcon Ridge Pkwy
Building 200 Suite a
Mesquite, NV 89027-8877
Phone (702) 346-3088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100719000303 NV Part A Provider - Hospice 7517099054 Practice locations: Mesquite, NV

Hospice certification: CCN 291529

Legal name
MESA VIEW HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 29, 2010
Last certification
Mar 18, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Apr 2, 2010 in NV
Enrollment address
330 Falcon Ridge Pkwy
Ste 200
Mesquite, NV 89027-8881

Care Compare: Hospice

Medicare Care Compare
Listed as
Mesa View Hospice, LLCCCN 291529
Ownership
For-Profit
Certified
Nov 29, 2010
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

330 Falcon Ridge Pkwy
Ste 200
Mesquite, NV 89027
Phone (702) 346-2460

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Travis Wakefield Individual 5% Or Greater Direct Ownership Interest Apr 2, 2010 20%
W-2 Managing EmployeeManaging Member Apr 2, 2010 20%
Ty Wakefield Individual 5% Or Greater Direct Ownership Interest Apr 2, 2010 20%
W-2 Managing EmployeeManaging Member Apr 2, 2010 20%
Shannel Rowley Individual 5% Or Greater Direct Ownership Interest Apr 2, 2010 20%
W-2 Managing EmployeeManaging Member, Administrator Apr 2, 2010 20%
Pamela Hendrix Individual 5% Or Greater Direct Ownership Interest Apr 2, 2010 20%
W-2 Managing EmployeeManaging Member, Director of Nur Apr 2, 2010 20%
Joseph Jeppson Individual Contracted Managing EmployeeMD; Aug 1, 2022
Teresa D Bowen Individual 5% Or Greater Direct Ownership Interest Apr 2, 2010 20%
W-2 Managing EmployeeManaging Member Jul 2, 2010 20%

Owners & managing parties with NPI records 1

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

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": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1134448475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FALCON RIDGE PKWY",
            "address_2": "BUILDING 200 SUITE A",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278877",
            "telephone_number": "702-346-3088",
            "fax_number": "702-346-3086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 FALCON RIDGE PKWY",
            "address_2": "BUILDING 200 SUITE A",
            "city": "MESQUITE",
            "state": "NV",
            "postal_code": "890278877",
            "telephone_number": "702-346-3088",
            "fax_number": "702-346-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA VIEW HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "ROWLEY",
        "authorized_official_first_name": "SHANNEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-346-3088",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NV",
            "license": "NV20101297547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, NV

Sources for this page

Verify at the official NPI Registry.