NPIMap

Organization Active NPI

Tabitha, Inc.

Doing business as Tabitha Hospice

  • Community Based Hospice Care Agency
  • Lincoln, NE
National Provider Identifier
1275618753
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HOSPICE15 Issued in NE
Legal business name
TABITHA, INC.
Doing business as
Tabitha Hospice
Practice address
4720 Randolph Street
Lincoln, NE 68510-3741
Phone
(402) 420-2273
NPI assigned
Oct 25, 2006
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Renae Endicott
Title
Assistant Director of Finance
Phone
(402) 484-9711

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HOSPICE 15 NE
Community Based Hospice Care Agency 251G00000X HOSPICE15 NE Primary

Addresses

Primary practice location

4720 Randolph Street
Lincoln, NE 68510-3741

Mailing address

4720 Randolph St
Lincoln, NE 68510-3741

Other identifiers 3

IdentifierTypeStateIssuer
00391OtherNEHOSPICE (BCBS OF NE)
08982OtherNEDME/SUPPLIES (BCBS OF NE)
10025149200MedicaidNE

Other names 1

  • Tabitha Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040722000967 NE Part A Provider - Hospice 3274421284 Practice locations: Grand Island, NE; York, NE; Lincoln, NE
O20050201000661 NE Part B Supplier - Clinic/Group Practice 3274421284 Receives reassigned benefits from 1 practitioner
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Franklin, NE; Holdrege, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275618753. Details of each certification follow.

Hospice certification: CCN 281502

Legal name
TABITHA, INC.
Doing business as
EVENTIDE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 1, 1987
Last certification
Dec 29, 2021
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Enrollment address
4720 Randolph St
Lincoln, NE 68510-3741

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Eventide HospiceCCN 281502 · All quality measures
Ownership
Non-Profit
Certified
Dec 1, 1987
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Tabitha Health Care Ser10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Jon M Riewer Individual Corporate OfficerPresident & Ceo Oct 10, 2024
Karla Swenson Individual Corporate Director Oct 10, 2024
Eric Schafer Individual Corporate Director Jan 1, 2013
Eventide Nebraska Senior Living LLC Organization, Moorhead, MN LLC, Non-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 10, 2024 100%
Darin G Ohe Individual Operational/Managerial ControlCfo Oct 10, 2024
Robert J Bye Individual Corporate Officer Oct 10, 2024
Corporate Director Oct 10, 2024
Peter J Seljevold Individual Corporate Director Oct 10, 2024
Brandon Lunak Individual Corporate OfficerTreasurer Apr 1, 2026
Corporate Director Oct 10, 2024
Karen Cheesman Individual W-2 Managing EmployeeAd; Dec 1, 2020
Tyler Fischbach Individual Corporate Director Oct 10, 2024
Jodee Bock Individual Corporate Director Oct 10, 2024
Patrick Gulbranson Individual Corporate Director Oct 10, 2024
Terry Brandt Individual Corporate Director Oct 10, 2024
Jeffrey T Marple Individual Contracted Managing EmployeeMD; Apr 1, 2022
Heather M Fago Individual Contracted Managing EmployeeMD; Jan 1, 2008
Kevin J Reichmuth Individual Contracted Managing EmployeeMD; Jan 1, 2017
Eventide Organization, Moorhead, MN Corporation, Non-profit, Chain home office Operational/Managerial Control Oct 10, 2024 100%
Judith Lee Individual Corporate Director Oct 10, 2024
Cindy Larson-Casselton Individual Corporate Director Oct 10, 2024
Vikki Johnson Individual Corporate Officer Oct 10, 2024
Corporate Director Oct 10, 2024

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Eventide Prairie Commons Care CenterGrand Island, NE, CCN 285307 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 22, 2022
Tabitha Hospice-a Collaboration With ImmanuelOmaha, NE, CCN 281556 Hospice 5% Or Greater Direct Ownership Interest (75%) Dec 13, 2021

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 3

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.

Affiliated clinicians 38

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1275618753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 RANDOLPH ST",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 RANDOLPH STREET",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685103741",
            "telephone_number": "402-420-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TABITHA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2025-09-02",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "ENDICOTT",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "ASSISTANT DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "402-484-9711"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE 15",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NE",
            "license": "HOSPICE15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOSPICE (BCBS OF NE)",
            "identifier": "00391",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME/SUPPLIES (BCBS OF NE)",
            "identifier": "08982",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025149200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tabitha Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.