Organization Active NPI

Mountain View Hospice LLC

  • Community Based Hospice Care Agency
  • Peoria, AZ
National Provider Identifier
1346725181
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MOUNTAIN VIEW HOSPICE LLC
Practice address
8263 W Thunderbird Rd Ste 120
Peoria, AZ 85381-4615
Phone
(623) 230-3698
Fax
(623) 215-6042
NPI assigned
Sep 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Amiee Joint
Title
Owner
Phone
(623) 230-3698

Specialties & licenses 1

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

Addresses

Primary practice location

8263 W Thunderbird Rd Ste 120
Peoria, AZ 85381-4615

Mailing address

8263 W Thunderbird Rd
Peoria, AZ 85381-4615

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181219001106 AZ Part A Provider - Hospice 7810232881 Practice locations: Peoria, AZ

Hospice certification: CCN 031689

Legal name
MOUNTAIN VIEW HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 4, 2019
Last certification
Mar 4, 2019
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Jul 26, 2018 in AZ
Enrollment address
8263 W Thunderbird Rd
Ste 120
Peoria, AZ 85381-4615

Care Compare: Hospice

Medicare Care Compare
Listed as
Mountain View Hospice, LLCCCN 031689 · All quality measures
Ownership
Other
Certified
Mar 4, 2019
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
03D2157691Mountain View Hospice LLC8263 W Thunderbird Rd, Ste 120, Peoria, AZ 85381Certificate of waiverNov 8, 2026

National Provider Directory

National Provider Directory

Locations

8263 W Thunderbird Rd
Peoria, AZ 85381

8263 W Thunderbird Rd
Ste 120
Peoria, AZ 85381
Phone (623) 230-3698

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Kulbhushan Paul Individual Contracted Managing EmployeeMedical Director Dec 10, 2018 15%
Jaime Wasden Ryum Individual 5% Or Greater Direct Ownership InterestAdministrator Sep 25, 2023 50%
Corporate DirectorSecretary Treasurer Board Member Jul 26, 2018 50%
W-2 Managing EmployeeAdministrator Nov 5, 2018 100%
Amiee Joint Individual 5% Or Greater Direct Ownership Interest Sep 25, 2023 50%
Corporate DirectorPresident Board Member Jul 26, 2018 25%
W-2 Managing EmployeePresident Board Member Jul 26, 2018 100%
Tammra Brougher Individual W-2 Managing EmployeeDirector of Clinical Services Dec 27, 2023 25%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1346725181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8263 W THUNDERBIRD RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8263 W THUNDERBIRD RD STE 120",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814615",
            "telephone_number": "623-230-3698",
            "fax_number": "623-215-6042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "JOINT",
        "authorized_official_first_name": "AMIEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-230-3698"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.