NPIMap

Organization Active NPI

The University of Kansas Health System Hospice - Great Bend, LLC

Doing business as Golden Belt Hospice

  • Community Based Hospice Care Agency
  • Great Bend, KS
National Provider Identifier
1376330456
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
THE UNIVERSITY OF KANSAS HEALTH SYSTEM HOSPICE - GREAT BEND, LLC
Doing business as
Golden Belt Hospice
Practice address
3421 Forest Ave
Great Bend, KS 67530-3605
Phone
(620) 792-8171
NPI assigned
Apr 22, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Dr. Bradley A Appl
Title
President & Vice Chair
Phone
(620) 792-8171

Specialties & licenses 1

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

Addresses

Primary practice location

3421 Forest Ave
Great Bend, KS 67530-3605

Mailing address

3421 Forest Ave
Great Bend, KS 67530-3605
Phone (620) 792-8171

Other names 1

  • Golden Belt Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250827004843 KS Part A Provider - Hospice 5092216564 Practice locations: Great Bend, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376330456. Details of each certification follow.

Hospice certification: CCN 171512

Legal name
THE UNIVERSITY OF KANSAS HEALTH SYSTEM HOSPICE - GREAT BEND LLC
Doing business as
GOLDEN BELT HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 3, 1992
Last certification
May 2, 2019
Ownership / control type
Non-Profit - Other
Organization structure
LLCProprietary
Enrollment address
3421 Forest Ave
Great Bend, KS 67530-3605

Care Compare: Hospice

Medicare Care Compare
Listed as
Golden Belt HospiceCCN 171512 · All quality measures
Ownership
For-Profit
Certified
Jun 3, 1992
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Jason Grundstrom Individual Corporate OfficerVice President Jun 1, 2025
Corporate DirectorBoard Chair Jun 1, 2025
Gunnar J Appl Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 14%
Cory Matthew Appl Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 14%
Jessica L Kalender-Rich Individual Corporate DirectorBoard Member Jun 1, 2025
Micca M Schneider Individual W-2 Managing EmployeeMD; Jun 1, 2025
Bradley a Appl Individual 5% Or Greater Indirect Ownership InterestPresident Jun 1, 2025 14%
Corporate OfficerPresident Jun 1, 2025
Corporate DirectorBoard Member Jun 1, 2025
Home Health and Hospice Holding Company LLC Organization, Shawnee, KS LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2025 100%
Zackary K Appl Individual Corporate OfficerController Jun 1, 2025
Christopher K Wilson Individual Corporate DirectorBoard Member Jun 1, 2025
Appl Holdco, Inc. Organization, Shawnee, KS Corporation, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 70%
Allison a Stewart Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 14%
Corporate DirectorBoard Member Jun 1, 2025
Sheryl Watts Individual W-2 Managing EmployeeAlt Administrator Jun 1, 2025
Cambridge Ventures, LLC Organization, Westwood, KS LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 30%
Donita M. Wolf Individual W-2 Managing EmployeeAd; Jun 1, 2025
Clay T Appl Individual 5% Or Greater Indirect Ownership Interest Jun 1, 2025 14%
Corporate DirectorBoard Member Jun 1, 2025
Eileen M Orel Individual Corporate OfficerSecretary Jun 1, 2025
W-2 Managing EmployeeSecretary Jun 1, 2025
University of Kansas Hospital Authority Organization, Kansas City, KS Non-profit 5% Or Greater Indirect Ownership Interest Jun 1, 2025 29.7%

Owners & managing parties with NPI records 14

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

View all 14

Facilities with the same owner 25

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

View all 25

Change-of-ownership history 1

DateEventCounterparty
Jun 1, 2025 Change of OwnershipThis provider was the buyer Golden Belt HospiceCCN 171512, KS, NPI 1710454731

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1376330456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 FOREST AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303605",
            "telephone_number": "620-792-8171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 FOREST AVE",
            "city": "GREAT BEND",
            "state": "KS",
            "postal_code": "675303605",
            "telephone_number": "620-792-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE UNIVERSITY OF KANSAS HEALTH SYSTEM HOSPICE - GREAT BEND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "APPL",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT & VICE CHAIR",
        "authorized_official_telephone_number": "620-792-8171",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Belt Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Golden Belt Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Great Bend, KS

Sources for this page

Verify at the official NPI Registry.