Heartland Hospice Services, LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

HEARTLAND HOSPICE SERVICES, LLC

Practice address

695 Kenmoor Ave SE Ste B
Grand Rapids, MI 49546-2375

Phone

(616) 956-0636

NPI assigned

Sep 14, 2022

Organization subpart

Yes

Parent organization

HEARTLAND HOSPICE SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Martin David Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Grand Rapids) Doing business as

Part of

Heartland Hospice-Tulsa

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1326760554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 KENMOOR AVE SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462375",
            "telephone_number": "616-956-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "enumeration_date": "2022-09-14",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1413573",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Grand Rapids)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Hospice and Palliative Medicine (Internal Medicine) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; 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.