Shooting Star Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SHOOTING STAR HOSPICE CARE INC

Practice address

3558 Round Barn Blvd Ste 213
Santa Rosa, CA 95403-1780

Phone

(707) 324-1001

NPI assigned

Apr 16, 2021

Last updated

Apr 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Avetis Timeuryan

Title

Ceo

Phone

(707) 324-1001

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1255912747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3558 ROUND BARN BLVD STE 213",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3558 ROUND BARN BLVD STE 213",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031780",
            "telephone_number": "707-324-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOOTING STAR HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "TIMEURYAN",
        "authorized_official_first_name": "AVETIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "707-324-1001"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Shirlock
• Danielle Shoaf
• Nazanin Sadet Shobeiri, PT
• Haley Shoemaker, B.A.
• Paul Richard Shonka, D.P.M.
• Ayne Shore, MFT
• Shane Michael Short
• Casandra Camacho Shotwell, PH.D.
• Prastuti Shrestha, M.D.
• Imani Danielle Shubin

• Community Based Hospice Care Agency in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.