NPIMap

Organization Active NPI

Frederick Health Hospital Inc

Doing business as Frederick Health Hospice

  • Community Based Hospice Care Agency
  • Frederick, MD
National Provider Identifier
1205832268
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
H1516 Issued in MD
Legal business name
FREDERICK HEALTH HOSPITAL INC
Doing business as
Frederick Health Hospice
Practice address
1 Frederick Health Way
Frederick, MD 21701-9435
Phone
(240) 566-3030
NPI assigned
Jun 24, 2005
Last updated
Mar 17, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
FREDERICK HEALTH HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

Name
Jenny Fitzpatrick
Title
Director, Professional Fees Revenue
Phone
(240) 439-8774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X H1516 MD Primary

Addresses

Primary practice location

1 Frederick Health Way
Frederick, MD 21701-9435

Mailing address

400 W 7TH St
Frederick, MD 21701-4506
Phone (240) 566-3030

Other identifiers 1

IdentifierTypeStateIssuer
212765207MedicaidMD

Other names 2

  • Frederick Health Hospice Doing business as
  • Frederick Memorial Hospital Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040528000756 MD Part A Provider - Hospice 0446149256 Practice locations: Frederick, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205832268. Details of each certification follow.

Hospice certification: CCN 211516

Legal name
FREDERICK HEALTH HOSPITAL INC
Doing business as
FREDERICK HEALTH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 26, 1990
Last certification
May 25, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
May 22, 1897 in MD
Enrollment address
1 Frederick Health Way
Frederick, MD 21701-9435

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Frederick Health HospiceCCN 211516 · All quality measures
Ownership
Non-Profit
Certified
Jul 26, 1990
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2166881Frederick Health Hospice1 Frederick Health Way, Frederick, MD 21701Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Frederick Mem Hosp Inc36 organizations share this tax ID, including this one
Part of
Frederick Mem Hosp Inc

Other organizations with this tax ID 35

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

View all 35

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elizabeth B Pakenas Individual Corporate DirectorBoard Member Oct 1, 2014
Gordon M Cooley Individual Corporate DirectorBoard Member Oct 1, 2018
Michelle Mahan Individual Corporate Director Jan 1, 2009
James Frederick Manning Individual Corporate DirectorBoard Member Oct 1, 2010
Carlos Tomas Graveran Individual W-2 Managing EmployeeDirector Jul 5, 2016 100%
Thomas Kleinhanzl Individual Corporate Director Dec 1, 2007
Jennifer Teeter Individual W-2 Managing Employee Dec 1, 2007
Shelby Boggs Individual W-2 Managing EmployeeAvp Clinical Integration Jul 6, 2021
Stephen L Johnson Individual Corporate DirectorBoard Member Oct 1, 2015

Practitioners & affiliated clinicians

Affiliated clinicians 82

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

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1205832268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W 7TH ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217014506",
            "telephone_number": "240-566-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREDERICK HEALTH WAY",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217019435",
            "telephone_number": "240-566-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK HEALTH HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDERICK HEALTH HOSPITAL INC",
        "enumeration_date": "2005-06-24",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "DIRECTOR, PROFESSIONAL FEES REVENUE",
        "authorized_official_telephone_number": "240-439-8774"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MD",
            "license": "H1516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212765207",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frederick Health Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Frederick Health Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Frederick Memorial Hospital Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.