Emerald Wings Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EMERALD WINGS HOSPICE LLC

Practice address

889 Grand Ave # 201
Saint Paul, MN 55105-3008

Phone

(320) 232-9325

NPI assigned

Oct 24, 2023

Organization subpart

No

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

Authorized official

Name

Shelly Sowada

Title

Owner/President

Phone

(320) 232-9325

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Hospice certification: CCN 241626

Legal name

EMERALD WINGS HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 22, 2024

Last certification

Oct 10, 2024

Organization structure

LLCProprietary

Incorporated

Oct 24, 2023 in MN

Enrollment address

889 Grand Ave
# 201
Saint Paul, MN 55105-3008

Listed as

Emerald Wings Hospice LLCCCN 241626

Certified

Oct 22, 2024

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

Locations

All disclosed owners & managing parties 7

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 2

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

• Arnes Huskic, M.D.

  • Surgery Physician
  • Saint Cloud, MN
  • NPI 1174987275

  W-2 Managing Employee

  CMS ownership
• Berit L Amundson, MD

  • Family Medicine Physician
  • Jackson, WY
  • NPI 1790009454

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Berit L Amundson, MD

  • Family Medicine Physician
  • Jackson, WY
  • NPI 1790009454
  NPD (past)

Affiliated clinicians 2

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

• Kourtny Long, PA-C

  • Physician Assistant
  • Stillwater, MN
  • NPI 1659761898

  Hospice

  Care Compare affiliation
• Berit L Amundson, MD

  • Family Medicine Physician
  • Jackson, WY
  • NPI 1790009454

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698105600000",
    "number": "1194597005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 GRAND AVE # 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053008",
            "telephone_number": "320-232-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "889 GRAND AVE # 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053008",
            "telephone_number": "320-232-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD WINGS HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A",
        "authorized_official_last_name": "SOWADA",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "320-232-9325"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Saint Paul, MN by specialty
• Community Based Hospice Care Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; 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.