NPIMap

Organization Active NPI

Lester Dierksen Memorial Hospice LLC

  • Community Based Hospice Care Agency
  • Jonesboro, AR
National Provider Identifier
1275814154
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LESTER DIERKSEN MEMORIAL HOSPICE LLC
Doing business as
Dierksen Memorial Hospice
Practice address
4315 E Johnson Ave
Jonesboro, AR 72401-8839
Phone
(870) 932-2880
NPI assigned
Sep 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Jesse R Moore
Title
Chief Administrative Officer
Phone
(857) 331-6271

Specialties & licenses 1

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

Addresses

Primary practice location

4315 E Johnson Ave
Jonesboro, AR 72401-8839

Mailing address

500 Faulconer Dr Ste 200
Charlottesville, VA 22903-5089
Phone (434) 977-9711

Other names 1

  • Dierksen Memorial Hospice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dierksen Memorial Hospice5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

4315 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 932-2880

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1275814154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 FAULCONER DR STE 200",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229035089",
            "telephone_number": "434-977-9711",
            "fax_number": "434-235-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 E JOHNSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724018839",
            "telephone_number": "870-932-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESTER DIERKSEN MEMORIAL HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "857-331-6271"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dierksen Memorial Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.