Organization Active NPI

Hospice Advantage, LLC.

  • Community Based Hospice Care Agency
  • Columbia, MO
National Provider Identifier
1144526641
Registry record updated Jul 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
203-HO Issued in MO
Legal business name
HOSPICE ADVANTAGE, LLC.
Practice address
2620 Forum Blvd
Suite E
Columbia, MO 65203-5454
Phone
(573) 442-9104
Fax
(573) 442-9124
NPI assigned
Jan 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2014

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

Authorized official

Name
Kaye Mynsberge
Title
Coo
Phone
(989) 891-2210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 203-HO MO Primary

Addresses

Primary practice location

2620 Forum Blvd
Suite E
Columbia, MO 65203-5454

Mailing address

401 Center Ave
Bay City, MI 48708-5939
Phone (989) 891-2206

Other identifiers 1

IdentifierTypeStateIssuer
1144526641MedicaidMO

Other names 1

  • Hospice Advantage, Inc. Former legal business name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1144526641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 CENTER AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487085939",
            "telephone_number": "989-891-2206",
            "fax_number": "989-893-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 FORUM BLVD",
            "address_2": "SUITE E",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652035454",
            "telephone_number": "573-442-9104",
            "fax_number": "573-442-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE ADVANTAGE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-31",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "MYNSBERGE",
        "authorized_official_first_name": "KAYE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "989-891-2210"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "203-HO",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144526641",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hospice Advantage, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.