Active NPI
Hospice of Kona, Inc.
- Community Based Hospice Care Agency
- Kailua Kona, HI
National Provider Identifier
1356409270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- HOSPICE OF KONA, INC.
- Practice address
- 75-5925 Walua Road
Kailua Kona, HI 96740 - Phone
- (808) 324-7700
- Fax
- (808) 331-0767
- NPI assigned
- Dec 4, 2006
- 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
- Ms. Laura Varney
- Title
- Chief Executive Offi
- Phone
- (808) 324-7700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
75-5925 Walua Road
Kailua Kona, HI 96740
Mailing address
PO Box 4130
Kailua Kona, HI 96745-4130
Phone (808) 324-7700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24751001 | Medicaid | HI | |
| 9381-5 | Other | HI | PROVIDER ID |
| 024751001 | Medicaid | HI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070413000391 | HI | Part A Provider - Hospice | 5991800336 | Practice locations: Kailua Kona, HI |
Hospice certification: CCN 121505
- Legal name
- HOSPICE OF KONA INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Feb 26, 1992
- Last certification
- Jun 8, 2018
- Ownership / control type
- Non-Profit - Other
- Organization structure
- Corporation
- Incorporated
- Aug 26, 1985 in HI
- Enrollment address
- 75-5925 Walua Rd
101
Kailua Kona, HI 96740-5311
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospice of Kona
- Ownership
- Non-Profit
- Certified
- Feb 26, 1992
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Hospice of Kona
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Kailua Kona, HI
- NPI 1659379980
Locations
75-5925 Walua Rd
Ste 101
Kailua Kona, HI 96740
Phone (808) 324-7700
Ownership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Mamie Bramlett | Corporate Director | Jul 1, 2014 | |
| Laura Varney | Corporate Officer | Mar 22, 2006 | 100% |
| W-2 Managing Employee | Mar 22, 2006 | 100% | |
| Arron Biber | Corporate Director | Jul 1, 2014 | |
| Scott Ast | Corporate Director | Apr 1, 2016 | |
| Koa Woolley | Corporate Director | Dec 1, 2016 | |
| Jennifer Shimada | Corporate Director | Jul 1, 2014 | |
| Kevin Shaw | Corporate Director | Dec 1, 2016 | |
| Darl Gleed | Corporate Director | May 1, 2015 | |
| Jacob Burrill | Corporate Director | Jul 1, 2017 | |
| Susana Bullard | Corporate Director | Jan 1, 2020 |
Practitioners & affiliated clinicians
Affiliated clinicians 5
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": "1165190400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1424217600000",
"number": "1356409270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4130",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "967454130",
"telephone_number": "808-324-7700",
"fax_number": "808-331-0767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75-5925 WALUA ROAD",
"city": "KAILUA KONA",
"state": "HI",
"postal_code": "96740",
"telephone_number": "808-324-7700",
"fax_number": "808-331-0767"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOSPICE OF KONA, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-04",
"last_updated": "2015-02-18",
"status": "A",
"authorized_official_last_name": "VARNEY",
"authorized_official_first_name": "LAURA",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFI",
"authorized_official_telephone_number": "808-324-7700",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "24751001",
"state": "HI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER ID",
"identifier": "9381-5",
"state": "HI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "024751001",
"state": "HI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kailua Kona, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.