Active NPI
Mountain View Hospice LLC
- Community Based Hospice Care Agency
- Peoria, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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, LLC
- Ownership
- Other
- Certified
- Mar 4, 2019
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2157691 | Mountain View Hospice LLC | Certificate of waiver | Nov 8, 2026 |
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Kulbhushan Paul | Contracted Managing Employee | Dec 10, 2018 | 15% |
| Jaime Wasden Ryum | 5% Or Greater Direct Ownership Interest | Sep 25, 2023 | 50% |
| Corporate Director | Jul 26, 2018 | 50% | |
| W-2 Managing Employee | Nov 5, 2018 | 100% | |
| Amiee Joint | 5% Or Greater Direct Ownership Interest | Sep 25, 2023 | 50% |
| Corporate Director | Jul 26, 2018 | 25% | |
| W-2 Managing Employee | Jul 26, 2018 | 100% | |
| Tammra Brougher | W-2 Managing Employee | 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.
-
- Internal Medicine Physician
- Peoria, AZ
- NPI 1376532127
Contracted Managing Employee
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.