NPIMap

Organization Active NPI

Onesource HPC LLC

  • Community Based Hospice Care Agency
  • Idaho Falls, ID
National Provider Identifier
1295960763
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ONESOURCE HPC LLC
Practice address
1680 Elk Creek Dr
Idaho Falls, ID 83404-1225
Phone
(208) 524-0685
Fax
(208) 524-0686
NPI assigned
May 27, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Jennifer Davis
Title
Coo
Phone
(208) 524-0685

Owners & managing parties with NPI records 1

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

Facilities with the same owner 8

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

Affiliated clinicians 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Onesource HospiceCCN 131565
Ownership
For-Profit
Certified
Oct 28, 2010
Medicare certification status
ActiveFrom the Provider of Services file

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150812008278 ID Part a Provider - Hospice 1153636642 Practice locations: Idaho Falls, ID

Hospice certification: CCN 131565

Medicare enrollment files
Legal name
ONESOURCE HPC LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 28, 2010
Last certification
Oct 28, 2010
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Nov 12, 2010 in ID
Enrollment address
1680 Elk Creek Dr
Idaho Falls, ID 83404-1225

All disclosed owners & managing parties 8

Medicare enrollment files

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

NameRoleSinceShare
HBB Investments LLC Organization, Idaho Falls, ID LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 5%
Angela Hilleshiem Individual Corporate OfficerPresident Jun 1, 2023 100%
A Hilleshiem Consulting Organization, Eagle, ID LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 5%
Cabj Investments Organization, Meridian, ID LLC 5% Or Greater Indirect Ownership Interest Jun 1, 2023 15%
Christian T Shull Individual Contracted Managing EmployeeMD; Aug 22, 2019
Lisa Janikowski Individual W-2 Managing EmployeeAdministrator Oct 1, 2023
Jennifer L Davis Individual W-2 Managing EmployeeCoo Jun 1, 2023
Edgewood Op Co LLC Organization, Grand Forks, ND LLC 5% Or Greater Direct Ownership Interest Jun 1, 2023 100%

National Provider Directory

National Provider Directory

Locations

3544 E 17th St
#201
Ammon, ID 83406
Phone (208) 524-0685

1951 Bench Rd
Ste G
Pocatello, ID 83201
Phone (208) 478-1448

36 Winn Dr
#200
Rexburg, ID 83440
Phone (208) 356-0833

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

1680 Elk Creek Dr
Idaho Falls, ID 83404-1225

Mailing address

1680 Elk Creek Dr
Idaho Falls, ID 83404-1225
Phone (208) 524-0685

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 26, 2023.

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1295960763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834041225",
            "telephone_number": "208-524-0685",
            "fax_number": "208-524-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834041225",
            "telephone_number": "208-524-0685",
            "fax_number": "208-524-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONESOURCE HPC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "208-524-0685"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.