Organization Active NPI

In Home Health LLC

Doing business as Heartland Hospice Services

  • Community Based Hospice Care Agency
  • Macon, GA
National Provider Identifier
1184670648
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
IN HOME HEALTH LLC
Doing business as
Heartland Hospice Services
Practice address
5400 Riverside Dr Ste 200
Macon, GA 31210-0816
Phone
(478) 477-0101
Fax
(478) 477-9951
NPI assigned
May 26, 2006
Last updated
Dec 6, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Authorized official

Name
Mr. Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary
Inpatient Hospice 315D00000X NU

Addresses

Primary practice location

5400 Riverside Dr Ste 200
Macon, GA 31210-0816

Mailing address

333 N Summit St
Attn: Dean Shipman
Toledo, OH 43604-2615
Phone (419) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
000848317DMedicaidGA

Other names 1

  • Heartland Hospice Services 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

Locations

3312 Northside Dr
Ste D250
Macon, GA 31210
Phone (478) 477-0101

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the seller Heartland Hospice (Macon)CCN 111603, GA, NPI 1316646508

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": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575590400000",
    "number": "1184670648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "ATTN: DEAN SHIPMAN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 RIVERSIDE DR STE 200",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100816",
            "telephone_number": "478-477-0101",
            "fax_number": "478-477-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2019-12-06",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000848317D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Hospice Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Hospice Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.