NPIMap

Organization Active NPI

Catholic Community Hospice of Northeast Kansas Inc

  • Community Based Hospice Care Agency
  • Lenexa, KS
National Provider Identifier
1316976103
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CATHOLIC COMMUNITY HOSPICE OF NORTHEAST KANSAS INC
Practice address
16201 W 95TH St
Lenexa, KS 66219-1220
Phone
(913) 621-5090
Fax
(913) 371-3080
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Bridgette Gregory
Title
Business Office Manager
Phone
(913) 433-2029

Specialties & licenses 1

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

Addresses

Primary practice location

16201 W 95TH St
Lenexa, KS 66219-1220

Mailing address

16201 W 95TH St Ste 220
Lenexa, KS 66219-1217
Phone (913) 621-5090

Other identifiers 1

IdentifierTypeStateIssuer
100008100DMedicaidKS

Other names 1

  • Catholic Community Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210723002405 KS Part A Provider - Hospice 3678976966 Practice locations: Lenexa, KS

Hospice certification: CCN 171540

Legal name
CATHOLIC COMMUNITY HOSPICE OF NORTHEAST KANSAS, INC
Doing business as
CATHOLIC COMMUNITY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 24, 1998
Last certification
Apr 13, 2018
Ownership / control type
Non-Profit - Church
Organization structure
CorporationNon-profit
Incorporated
May 27, 2021 in KS
Enrollment address
16201 W 95TH St
Ste 220
Lenexa, KS 66219-1217

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
Catholic Comm HospiceCCN 171540
Ownership
Non-Profit
Certified
Apr 24, 1998
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D0859163Catholic Community Hospice of Northeast KS16201 W 95TH Street, Lenexa, KS 66219Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Catholic Charities of Northeast Kansas Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

16201 W 95th St
Lenexa, KS 66219
Phone (913) 621-5090

Ownership & related parties

All disclosed owners & managing parties 13

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

NameRoleSinceShare
Mary Bibler Individual Corporate DirectorBoard Member Jul 1, 2021
Allen Strain Individual Corporate DirectorBoard Member Jul 1, 2021
Craig a Wohler Individual Corporate DirectorBoard Member Jul 1, 2021
Philip Glasser Individual Corporate DirectorBoard Member Jul 1, 2021
Gary J Pennings Individual Corporate OfficerSecretary Jul 1, 2021
Corporate DirectorBoard Member Jul 1, 2021
Patricia Markey Individual Corporate DirectorBoard Member Jul 1, 2021
Duke Onkoba Individual Corporate DirectorExecutive Director Jul 6, 2022
W-2 Managing EmployeeExecutive Director/Clinical Directo Jul 1, 2021
Thomas Bickimer Individual Corporate DirectorBoard Member Jul 1, 2021
Mark McKinzie Individual Corporate DirectorBoard Member Jul 1, 2021
Brett a Parise Individual Corporate DirectorBoard Member Jul 1, 2021
Nicole Anthony Individual Corporate OfficerCfo Jul 1, 2021
Scott Heady Individual Corporate DirectorBoard Member Jul 1, 2021
Mary E Decoursey Individual Corporate DirectorBoard Member Jul 1, 2021

Change-of-ownership history 2

DateEventCounterparty
Jul 1, 2021 Change of OwnershipThis provider was the buyer Catholic Community HospiceCCN 171540, KS, NPI 1316976103
Jul 1, 2021 Change of OwnershipThis provider was the seller Catholic Community HospiceCCN 171540, KS, NPI 1316976103

Practitioners & affiliated clinicians

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1316976103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16201 W 95TH ST STE 220",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191217",
            "telephone_number": "913-621-5090",
            "fax_number": "913-371-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16201 W 95TH ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662191220",
            "telephone_number": "913-621-5090",
            "fax_number": "913-371-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC COMMUNITY HOSPICE OF NORTHEAST KANSAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "BRIDGETTE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "913-433-2029"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100008100D",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Community Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Catholic Community Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lenexa, KS

Sources for this page

Verify at the official NPI Registry.