NPIMap

Organization Active NPI

Prime Home Care LLC

Doing business as Compassionate Care Hospice

  • Community Based Hospice Care Agency
  • Omaha, NE
National Provider Identifier
1265589220
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOSPICE33 Issued in NE
Legal business name
PRIME HOME CARE LLC
Doing business as
Compassionate Care Hospice
Practice address
6818 Grover St
Suite 201
Omaha, NE 68106-3640
Phone
(402) 390-2492
Fax
(402) 390-9070
NPI assigned
Jan 4, 2007
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Mrs. Tammy Kirsch, RN
Title
Administrator
Phone
(402) 390-2492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOSPICE33 NE Primary

Addresses

Primary practice location

6818 Grover St
Suite 201
Omaha, NE 68106-3640

Mailing address

6818 Grover St
Suite 201
Omaha, NE 68106-3640
Phone (402) 390-2492

Other identifiers 1

IdentifierTypeStateIssuer
100257364-00MedicaidNE

Other names 1

  • Compassionate Care Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050422000912 NE Part A Provider - Hospice 3072573484 Practice locations: Omaha, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265589220. Details of each certification follow.

Hospice certification: CCN 281535

Legal name
PRIME HOME CARE LLC
Doing business as
COMPASSIONATE CARE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 11, 2003
Last certification
Jun 23, 2021
Ownership / control type
Proprietary - Other
Organization structure
LLCProprietary
Incorporated
Sep 23, 2004 in NE
Enrollment address
6818 Grover St
Ste 101
Omaha, NE 68106-3632

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
Compassionate Care HospiceCCN 281535 · All quality measures
Ownership
For-Profit
Certified
Jul 11, 2003
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

6818 Grover St
Ste 101
Omaha, NE 68106
Phone (402) 390-2492

6818 Grover St
Ste 201
Omaha, NE 68106
Phone (402) 390-2492

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Tammy J Kirsch Individual Corporate OfficerVice President Sep 23, 2004
W-2 Managing EmployeeAdministrator Jan 18, 2005
Jacqueline Kay Ross Individual 5% Or Greater Direct Ownership Interest Sep 23, 2004 100%
Corporate OfficerPresident Sep 23, 2004

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1265589220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 GROVER ST",
            "address_2": "SUITE 201",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063640",
            "telephone_number": "402-390-2492",
            "fax_number": "402-390-9070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 GROVER ST",
            "address_2": "SUITE 201",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681063640",
            "telephone_number": "402-390-2492",
            "fax_number": "402-390-9070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "KIRSCH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "402-390-2492",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100257364-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassionate Care Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.