Bristol Hospice - Utah, L.L.C.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BRISTOL HOSPICE - UTAH, L.L.C.

Practice address

1638 N Washington Blvd
Ogden, UT 84404-3763

Phone

(801) 924-0867

Fax

(801) 747-3864

NPI assigned

Sep 14, 2006

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 Mauricio

Title

President/Ceo

Phone

(801) 325-0175

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Hospice certification: CCN 461566

Legal name

BRISTOL HOSPICE - UTAH, L.L.C.

Certification status

Active

Provider type (POS)

Hospice

Participating since

May 14, 2007

Last certification

Dec 29, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Sep 8, 2006 in UT

Enrollment address

1638 N Washington Blvd
Ste 102
Ogden, UT 84404-3790

Listed as

Bristol Hospice - Utah, LLCCCN 461566

Ownership

For-Profit

Certified

May 14, 2007

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.

• Richard E Allen, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1831174226

  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 - Utah II, L.L.C.

  • Community Based Hospice Care Agency
  • Murray, UT
  • NPI 1619253606

  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 - 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

Affiliated clinicians 1

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

• Tyler Mark Nixon, DO

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1669639985

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771804800000",
    "number": "1164527792",
    "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": "1638 N WASHINGTON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844043763",
            "telephone_number": "801-924-0867",
            "fax_number": "801-747-3864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPICE - UTAH, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-02-23",
        "certification_date": "2026-02-23",
        "status": "A",
        "authorized_official_last_name": "MAURICIO",
        "authorized_official_first_name": "ALEX",
        "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": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164527792",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kelly Jean Brinkerhoff, NURSE PRACTITIONER
• Gary V Broadbent, LCSW
• Jeffrey P Broadbent, DMD
• Michael William Broadbent, DMD, M.S.
• Melanie Ann Broadhead
• Mark Steven Broccardo, COTA

• All providers in Ogden, UT
• Community Based Hospice Care Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2026; 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.