NPIMap

Organization Active NPI

North Hawaii Hospice Inc

  • Community Based Hospice Care Agency
  • Kamuela, HI
National Provider Identifier
1265428510
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
NORTH HAWAII HOSPICE INC
Practice address
65-1328 Kawaihae Rd
Kamuela, HI 96743-8448
Phone
(808) 885-7547
Fax
(808) 885-5592
NPI assigned
Sep 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Tanya Elise Dean
Title
Executive Director
Phone
(808) 885-7547

Specialties & licenses 1

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

Addresses

Primary practice location

65-1328 Kawaihae Rd
Kamuela, HI 96743-8448

Mailing address

65-1328 Kawaihae Rd
Kamuela, HI 96743-8448
Phone (808) 885-7547

Other identifiers 4

IdentifierTypeStateIssuer
005835OtherHIHMSA QUEST
053382OtherHIMEDICAID
0583-5OtherHIHMSA
0583-5OtherHIHMSA FED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040316001220 HI Part A Provider - Hospice 6002706876 Practice locations: Kamuela, HI

Hospice certification: CCN 121506

Legal name
NORTH HAWAII HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 6, 1992
Last certification
Jun 6, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 6, 1985 in HI
Enrollment address
65-1328 Kawaihae Rd
Kamuela, HI 96743-8448

Care Compare: Hospice

Medicare Care Compare
Listed as
North Hawaii Hospice, IncCCN 121506
Ownership
For-Profit
Certified
Aug 6, 1992
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

65-1328 Kawaihae Rd
Kamuela, HI 96743
Phone (808) 885-7547

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
John G Roth Individual Corporate Officer2ND VP Jul 1, 2017
Pat Bergin Individual Corporate DirectorBoard Member Jun 1, 2016
Brittney H Spivak Individual W-2 Managing EmployeeMD; Mar 1, 2024 10%
Virginia Flynn Individual Corporate DirectorBoard Member Jun 1, 2016
Wendy G Craven Individual Corporate DirectorBoard Member Jun 1, 2011
Margarita Scheffel Individual Corporate DirectorBoard Member Jul 1, 2017
Diana Mahaney Individual Corporate DirectorBoard Member Jun 1, 2011
Steve Kittell Individual Corporate DirectorBoard Member Jun 1, 2017
Susan Hunt Individual Corporate DirectorBoard Member Jun 1, 2017
Karyn Clay Individual Corporate Officer1St VP Jul 1, 2017
Jaisy Jardine Individual Corporate OfficerPresident of Board Jul 1, 2017
William S Lawrence Individual Corporate DirectorBoard Member Jul 1, 2010
Sue Neyens Individual Corporate DirectorBoard Member Jun 1, 2015
Bigette Nemchick Individual W-2 Managing EmployeeDirector of Clinical Services Mar 15, 2024 10%
Michael Petrosian Individual Corporate DirectorBoard Member Jun 1, 2015
Beverly L Dawson Individual Corporate DirectorBoard Member Jul 1, 2010
Faye a Mitchell Individual W-2 Managing EmployeeAd;Executive Director Mar 15, 2024 20%
Stephanie Ladwig Individual Corporate OfficerTreasurer-Board of Directors Jul 1, 2017
Corporate DirectorBoard Member Jun 1, 2013

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 12

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": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1265428510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65-1328 KAWAIHAE RD",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438448",
            "telephone_number": "808-885-7547",
            "fax_number": "808-885-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65-1328 KAWAIHAE RD",
            "city": "KAMUELA",
            "state": "HI",
            "postal_code": "967438448",
            "telephone_number": "808-885-7547",
            "fax_number": "808-885-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH HAWAII HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-885-7547",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA QUEST",
            "identifier": "005835",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "053382",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0583-5",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA FED",
            "identifier": "0583-5",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kamuela, HI

Sources for this page

Verify at the official NPI Registry.