Active NPI
Bristol Hospice - Richmond, L.L.C.
- Community Based Hospice Care Agency
- Richmond, VA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- BRISTOL HOSPICE - RICHMOND, L.L.C.
- Practice address
- 7400 Beaufont Springs Dr.
Ste 105
Richmond, VA 23225-5519 - Phone
- (804) 554-5530
- Fax
- (804) 552-6024
- NPI assigned
- May 12, 2022
- Organization subpart
- Yes
- Parent organization
- BRISTOL HOSPICE, L.L.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alex Mauricio
- Title
- President and Ceo
- Phone
- (801) 325-0175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
7400 Beaufont Springs Dr.
Ste 105
Richmond, VA 23225-5519
Mailing address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Other practice location 1
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230322001105 | VA | Part A Provider - Hospice | 6305210980 | Practice locations: Richmond, VA |
Hospice certification: CCN 491655
- Legal name
- BRISTOL HOSPICE - RICHMOND, L.L.C.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jun 14, 2023
- Last certification
- Jun 2, 2023
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- May 9, 2022 in VA
- Enrollment address
- 7400 Beaufont Springs Dr
Ste 105
Richmond, VA 23225-5519
Care Compare: Hospice
Medicare Care Compare- Listed as
- Bristol Hospice - Richmond, L.L.C.
- Certified
- Jun 14, 2023
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 49D2273930 | Bristol Hospice-Richmond, LLC | Certificate of waiver | Dec 20, 2026 |
National Provider Directory
National Provider Directory- Part of
- Bristol Hospice LLC
Locations
7400 Beaufont Spring Dr
Ste 105
North Chesterfield, VA 23225
Phone (804) 554-5530
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 100% |
| Alex Edward Mauricio | Corporate Officer | May 9, 2022 | |
| Corporate Director | May 9, 2022 | ||
| Webster Equity Partners Bristol CF LP | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 69.8% |
| Brett L Montgomery | Contracted Managing Employee | Dec 1, 2023 | |
| John Charles Garbarino | Corporate Officer | May 9, 2022 | |
| Corporate Director | May 9, 2022 | ||
| Webster Equity Partners IV Bristol CF LP | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 5.72% |
| Michael Derrick | Corporate Officer | Sep 1, 2023 | |
| Betty J Brennan | Corporate Director | Jun 14, 2023 | |
| Bristol Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 100% |
| Kristal M Bennett | W-2 Managing Employee | May 9, 2022 | |
| Hyrum Kirton | Corporate Director | Jun 14, 2023 | |
| Aware Super Pty, LTD. | 5% Or Greater Indirect Ownership Interest | Jun 14, 2023 | 8.28% |
| Bristol Hospice, L.L.C. | 5% Or Greater Direct Ownership Interest | May 9, 2022 | 100% |
| Bristol Hospice Topco Inc | 5% Or Greater Indirect Ownership Interest | May 9, 2022 | 100% |
| David a Malm | Corporate Officer | May 9, 2023 | |
| Corporate Director | May 9, 2023 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Richmond, VA
- NPI 1205033636
Contracted Managing Employee
Facilities with the same owner 52
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Virginia Beach, VA
- NPI 1962149740
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bangor, ME
- NPI 1336916469
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bend, OR
- NPI 1356916845
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Plymouth Meeting, PA
- NPI 1356118467
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Merced, CA
- NPI 1487603452
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- North Charleston, SC
- NPI 1326866963
Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Des Plaines, IL
- NPI 1104548478
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Springfield, OR
- NPI 1568962033
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Atlanta, GA
- NPI 1558663872
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Green Bay, WI
- NPI 1356928154
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Honolulu, HI
- NPI 1811045594
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Riverside, CA
- NPI 1043683170
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1652313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1694131200000",
"number": "1225774136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 N 2100 W STE 202",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841164741",
"telephone_number": "801-325-0175",
"fax_number": "801-478-3533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 BEAUFONT SPRINGS DR.",
"address_2": "STE 105",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232255519",
"telephone_number": "804-554-5530",
"fax_number": "804-552-6024"
}
],
"practiceLocations": [
{
"address_1": "206 N 2100 W Ste 202",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841164741",
"country_code": "US",
"telephone_number": "801-325-0175",
"fax_number": "801-478-3533",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BRISTOL HOSPICE - RICHMOND, L.L.C.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
"enumeration_date": "2022-05-12",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A",
"authorized_official_last_name": "MAURICIO",
"authorized_official_first_name": "ALEX",
"authorized_official_title_or_position": "PRESIDENT AND CEO",
"authorized_official_telephone_number": "801-325-0175"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.