NPIMap

Organization Active NPI

Granite Healthcare, Inc.

  • Community Based Hospice Care Agency
  • Centennial, CO
National Provider Identifier
1215340930
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GRANITE HEALTHCARE, INC.
Practice address
5161 E Arapahoe Rd Ste 320
Centennial, CO 80122-2385
Phone
(303) 730-3578
NPI assigned
Jun 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 369-7608

Specialties & licenses 1

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

Addresses

Primary practice location

5161 E Arapahoe Rd Ste 320
Centennial, CO 80122-2385

Mailing address

5161 E Arapahoe Rd Ste 320
Centennial, CO 80122-2385
Phone (303) 730-3578

Other names 1

  • Namaste Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140815001701 CO Part A Provider - Hospice 5496921439 Practice locations: Centennial, CO

Hospice certification: CCN 061545

Legal name
GRANITE HEALTHCARE, INC.
Doing business as
NAMASTE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 1, 1998
Last certification
Jun 23, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Aug 30, 2011 in NV
Enrollment address
5161 E Arapahoe Rd
Ste 320
Centennial, CO 80122-2385

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Namaste HospiceCCN 061545
Ownership
For-Profit
Certified
Sep 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Granite Healthcare Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

6000 E Evans Ave
Ste 2-400
Denver, CO 80222
Phone (303) 730-3578

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jackie Zinkgraf Individual W-2 Managing EmployeeAdministrator Feb 1, 2019
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 1, 2014 100%
Christopher S Horton Individual Contracted Managing EmployeeMedical Director Jun 27, 2018
Brent Mills Individual Corporate OfficerTreasurer Mar 26, 2026
Brent Guerisoli Individual Corporate DirectorDirector Jul 11, 2022
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
John J Gochnour Individual Corporate OfficerPresident Jul 23, 2024
Amber Tueller Individual Corporate OfficerSecretary Jul 23, 2024

Owners & managing parties with NPI records 1

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

Facilities with the same owner 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Practitioners & affiliated clinicians

Affiliated clinicians 6

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

NPI Registry JSON

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

{
    "created_epoch": "1402358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1215340930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5161 E ARAPAHOE RD STE 320",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801222385",
            "telephone_number": "303-730-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5161 E ARAPAHOE RD STE 320",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801222385",
            "telephone_number": "303-730-3578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-10",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-369-7608"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Namaste Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Namaste Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Centennial, CO

Sources for this page

Verify at the official NPI Registry.