NPIMap

Organization Active NPI

Preferred Hospice of Missouri Southwest LLC

Doing business as Preferred Hospice

  • Community Based Hospice Care Agency
  • Ozark, MO
National Provider Identifier
1306038948
Registry record updated Aug 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PREFERRED HOSPICE OF MISSOURI SOUTHWEST LLC
Doing business as
Preferred Hospice
Practice address
1567 West Diane
Suite B
Ozark, MO 65721
Phone
(417) 581-4968
NPI assigned
Aug 17, 2007
Last updated
Aug 17, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2007

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

Authorized official

Name
Mr. James C Lincoln
Title
President Ceo
Phone
(417) 581-4968

Specialties & licenses 1

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

Addresses

Primary practice location

1567 West Diane
Suite B
Ozark, MO 65721

Mailing address

1567 West Diane
Suite B
Ozark, MO 65721
Phone (417) 581-4968

Other names 1

  • Preferred Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070829000312 MO Part A Provider - Hospice 7012000508 Practice locations: Ozark, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306038948. Details of each certification follow.

Hospice certification: CCN 261635

Legal name
PREFERRED HOSPICE OF MISSOURI SOUTHWEST LLC
Doing business as
PREFERRED HOSPICE OF MISSOURI SOUTHWEST
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 11, 2008
Last certification
Nov 21, 2019
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Incorporated
May 16, 2007 in MO
Enrollment address
5340N Towne Centre Dr
Ozark, MO 65721-7477

Care Compare: Hospice

Medicare Care Compare
Listed as
Preferred Hospice of Missouri (Southwest), LLCCCN 261635 · All quality measures
Ownership
For-Profit
Certified
Aug 11, 2008
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1567 W Diane St
#B
Ozark, MO 65721
Phone (417) 581-4968

1567 W Diane St
Ste B
Ozark, MO 65721
Phone (417) 581-4968

5340 N Towne Centre Dr
Ozark, MO 65721
Phone (417) 581-4968

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Kimberly D Bremer Individual W-2 Managing EmployeeAdministrator Oct 10, 2016
Crown Trading Company Organization, Crescent, OK LLC 5% Or Greater Direct Ownership Interest Oct 2, 2007
Erica C McCombs Individual W-2 Managing EmployeeClinical Manager Aug 5, 2025
Donald R Chadwell Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2008 22.5%
Thomas E Dahlberg Individual W-2 Managing EmployeeMD; Mar 20, 2024
Brandon Lowder Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2008 2.5%
James C Lincoln Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2008 37.6%
Corporate OfficerManaging Member of the LLC Feb 1, 2008
JCJL Holdings LLC Organization, Sikeston, MO LLC 5% Or Greater Direct Ownership Interest Oct 1, 2010 75%
Horizon Capital LLC Organization, Oklahoma City, OK LLC 5% Or Greater Direct Ownership Interest Oct 17, 2007 25%
Judy L Lincoln Individual 5% Or Greater Indirect Ownership Interest Feb 1, 2008 37.5%

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Regional HospiceSpringfield, MO, CCN 261578 Hospice 5% Or Greater Direct Ownership Interest (25%) Jul 1, 2014

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Affiliated clinicians 11

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": "1187308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187308800000",
    "number": "1306038948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1567 WEST DIANE",
            "address_2": "SUITE B",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-581-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1567 WEST DIANE",
            "address_2": "SUITE B",
            "city": "OZARK",
            "state": "MO",
            "postal_code": "65721",
            "telephone_number": "417-581-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREFERRED HOSPICE OF MISSOURI SOUTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-17",
        "last_updated": "2007-08-17",
        "status": "A",
        "authorized_official_last_name": "LINCOLN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT CEO",
        "authorized_official_telephone_number": "417-581-4968",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preferred Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ozark, MO

Sources for this page

Verify at the official NPI Registry.