Dover Hospice Mo STL Metro, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

DOVER HOSPICE MO STL METRO, LLC

Practice address

300 Hunter Ave Ste 107
Saint Louis, MO 63124-2081

Phone

(314) 884-8817

Fax

(314) 627-4890

NPI assigned

Oct 31, 2023

Last updated

Nov 29, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Steven Burghart

Title

President

Phone

(305) 202-4545

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1326811563. Details of each certification follow.

• CCN 261709 Hospice · Active · Details

Hospice certification: CCN 261709

Legal name

DOVER HOSPICE MO STL METRO, LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jul 12, 2024

Last certification

Jul 3, 2024

Organization structure

LLCProprietary

Incorporated

Oct 23, 2023 in MO

Enrollment address

300 Hunter Ave
Ste 107
Saint Louis, MO 63124-2081

Listed as

Dover Hospice Mo STL Metro, LLCCCN 261709 · All quality measures

Certified

Jul 12, 2024

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 12

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

Owners & managing parties with NPI records 1

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

• Matthew J Gibfried, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1104887728

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 4

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

• Dover Home Health Mo STL Metro, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1891568168

  Dover Capital Management, Dover Health Holdings, LLC, Dover Health, LLC, Dover Holdings Management, LLC, Dover Holdings, LLC - Dover Health

  CMS ownership
• Dover Home Health Il Chicago Metro, LLC

  • Home Health Agency
  • Woodridge, IL
  • NPI 1275375446

  Dover Capital Management, Dover Health Holdings, LLC, Dover Health, LLC, Dover Holdings, LLC - Dover Health

  CMS ownership
• Dover Hospice Il Chicago Metro, LLC

  • Community Based Hospice Care Agency
  • Woodridge, IL
  • NPI 1811745730

  Dover Health Holdings, LLC, Dover Holdings, LLC - Dover Health, Dover Hospice, LLC

  CMS ownership
• Dover Hospice Il STL Metro, LLC

  • Community Based Hospice Care Agency
  • Glen Carbon, IL
  • NPI 1629822358

  Dover Capital Management, Dover Health Holdings, LLC, Dover Health, LLC, Dover Holdings Management, LLC, Dover Holdings, LLC - Dover Health, Dover Hospice, LLC

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew J Gibfried, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1104887728
  NPD (past)

Affiliated clinicians 3

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

• Matthew J Gibfried, MD

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1104887728

  Hospice

  Care Compare affiliation
• James R Grimes, M.D.

  • Family Medicine Physician
  • Warrenton, MO
  • NPI 1649262106

  Hospice

  Care Compare affiliation
• Kamlesh C Vyas, M.D,.

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1679551378

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1326811563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HUNTER AVE STE 200",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242328",
            "telephone_number": "314-884-8817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HUNTER AVE STE 107",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242081",
            "telephone_number": "314-884-8817",
            "fax_number": "314-627-4890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVER HOSPICE MO STL METRO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BURGHART",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-202-4545"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community Based Hospice Care Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.