NPIMap

Organization Active NPI

Optum Palliative and Hospice Care, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Henderson, NV
National Provider Identifier
1184166183
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
OPTUM PALLIATIVE AND HOSPICE CARE, INC.
Practice address
75 S Valle Verde Dr
Suite 100
Henderson, NV 89012-3462
Phone
(952) 205-1263
Fax
(844) 727-9218
NPI assigned
Nov 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Authorized official

Name
John O. Enderle
Title
Sr. VP/Cfo
Phone
(860) 221-0793

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PH0002X
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081H0002X
Hospice and Palliative Medicine (Radiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085H0002X

Addresses

Primary practice location

75 S Valle Verde Dr
Suite 100
Henderson, NV 89012-3462

Mailing address

1009 Windcross CT
Suite 101
Franklin, TN 37067-2678
Phone (615) 224-5443

Other names 1

  • Evercare Hospice, Inc. Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Evercare Hospice Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1478563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1184166183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 WINDCROSS CT",
            "address_2": "SUITE 101",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370672678",
            "telephone_number": "615-224-5443",
            "fax_number": "844-727-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S VALLE VERDE DR",
            "address_2": "SUITE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890123462",
            "telephone_number": "952-205-1263",
            "fax_number": "844-727-9218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM PALLIATIVE AND HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-08",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "ENDERLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "SR. VP/CFO",
        "authorized_official_telephone_number": "860-221-0793"
    },
    "taxonomies": [
        {
            "code": "207PH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2081H0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085H0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evercare Hospice, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.