NPIMap

Organization Active NPI

Good Shepherd Hospice, Inc.

  • Community Based Hospice Care Agency
  • Lakeland, FL
National Provider Identifier
1235283151
Registry record updated Jul 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
50060951 Issued in FL
Legal business name
GOOD SHEPHERD HOSPICE, INC.
Practice address
3470 Lakeland Hills Blvd
Lakeland, FL 33805-1946
Phone
(863) 682-0027
Fax
(863) 682-3006
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2025

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

Authorized official

Name
Crystal Bucciarelli
Title
VP, Legal Services
Phone
(813) 871-8075

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 50060951 FL Primary

Addresses

Primary practice location

3470 Lakeland Hills Blvd
Lakeland, FL 33805-1946

Mailing address

12470 Telecom Dr Ste 300W
Attention: Compliance
Temple Terrace, FL 33637-0904
Phone (813) 871-8400

Other identifiers 1

IdentifierTypeStateIssuer
150021000MedicaidFL

Other names 1

  • Good Shepherd Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081216000582 FL Part A Provider - Hospice 5799847331 Practice locations: Auburndale, FL; Lakeland, FL; Sebring, FL
O20131029001093 FL Part B Supplier - Clinic/Group Practice 5799847331 Receives reassigned benefits from 4 practitioners
Practice locations: Sebring, FL; Lakeland, FL; Auburndale, FL

Hospice certification: CCN 101550

Legal name
GOOD SHEPHERD HOSPICE, INC.
Doing business as
GOOD SHEPHERD HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 21, 2008
Last certification
Jul 23, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Enrollment address
3470 Lakeland Hills Boulevard
Lakeland, FL 33805-1946

Care Compare: Hospice

Medicare Care Compare
Listed as
Good Shepherd HospiceCCN 101550
Ownership
Non-Profit
Certified
Mar 21, 2008
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
10D1081050Good Shepherd Hospice, Inc3470 Lakeland Hills Blvd, Lakeland, FL 33805Certificate of waiverMar 9, 2028

National Provider Directory

National Provider Directory

Locations

3003 Herring Ave
Sebring, FL 33870

1110 Hammock Rd
Sebring, FL 33870
Phone (863) 402-1066

12470 Telecom Dr
Ste 301
Temple Terrace, FL 33637
Phone (423) 707-8678

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Stuart C Owens Individual W-2 Managing EmployeeMD; May 17, 2024
James Joiner Individual Corporate Officer May 15, 2014
Corporate Director Dec 4, 2007
Tara Friedman Individual Contracted Managing EmployeeChief Medical Officer May 17, 2024
Tracy Robert Individual Contracted Managing EmployeeVice President of Clinical Services May 17, 2024
Chapters Health System Inc Organization, Temple Terrace, FL Non-profit 5% Or Greater Direct Ownership Interest May 1, 2008 100%
Operational/Managerial Control May 1, 2008
Andrew K Molosky Individual Contracted Managing EmployeePresident/Ceo May 17, 2024
Todd a Webb Individual Contracted Managing EmployeeChief Financial Officer May 17, 2024
Rhonda G White Individual Contracted Managing EmployeePresident, Hospice and Pace May 17, 2024
Valerie Zolman Individual Contracted Managing EmployeeChief Compliance Officer May 17, 2024
Manfred Zenkner Individual W-2 Managing EmployeeExecutive Director Jun 26, 2017
Jason M D'Auria Individual Contracted Managing EmployeeChief Operating Officer, Hospice May 17, 2024
Sheri Strobel Individual Contracted Managing EmployeeChief Information Officer May 17, 2024
Anne Furr Individual Corporate DirectorVice Chair May 17, 2017
Harold Bennett Individual Corporate DirectorDirector May 17, 2024
Nicole Romence Individual Contracted Managing EmployeeChief People Officer May 17, 2024
Crystal Bucciarelli Individual Contracted Managing EmployeeVice President, Legal Services Jan 1, 2020
Corporate DirectorVice President, Legal Services Jan 1, 2020
Clifford Rhoades Individual Corporate Director Feb 15, 2017

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Medcare HospiceMiami, FL, CCN 101563 Hospice 5% Or Greater Direct Ownership Interest (20%) Aug 31, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 9

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 10

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

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753920000000",
    "number": "1235283151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12470 TELECOM DR STE 300W",
            "address_2": "ATTENTION: COMPLIANCE",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336370904",
            "telephone_number": "813-871-8400",
            "fax_number": "813-871-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338051946",
            "telephone_number": "863-682-0027",
            "fax_number": "863-682-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2025-07-31",
        "certification_date": "2025-07-31",
        "status": "A",
        "authorized_official_last_name": "BUCCIARELLI",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "VP, LEGAL SERVICES",
        "authorized_official_telephone_number": "813-871-8075"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "FL",
            "license": "50060951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150021000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Good Shepherd Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.