Anthem Hospice of Oklahoma City LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

4212 Issued in OK

Legal business name

ANTHEM HOSPICE OF OKLAHOMA CITY LLC

Practice address

425 W Wilshire Blvd Ste C
Oklahoma City, OK 73116-7794

Phone

(405) 724-6687

Fax

(405) 724-6491

NPI assigned

Feb 13, 2009

Organization subpart

No

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

Authorized official

Name

Joshua M Smith

Title

Partner

Phone

(763) 464-0717

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Good Journey Hospice, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Hospice certification: CCN 371660

Legal name

GOOD JOURNEY HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 21, 2005

Last certification

Jan 28, 2021

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Incorporated

Oct 20, 2008 in OK

Enrollment address

4020 N Lincoln Blvd
Ste 100
Oklahoma City, OK 73105-5201

Listed as

Anthem HospiceCCN 371660

Ownership

Other

Certified

Jun 21, 2005

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Larry J Coffman Sr., RN

  • Administrator Registered Nurse
  • Oklahoma City, OK
  • NPI 1508291055
  NPD (past)

Affiliated clinicians 1

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

• Waddah N. Nassar, M.D.

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1144252909

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1234483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1386883361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W WILSHIRE BLVD STE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167794",
            "telephone_number": "405-724-6687",
            "fax_number": "405-724-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W WILSHIRE BLVD STE C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731167794",
            "telephone_number": "405-724-6687",
            "fax_number": "405-724-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHEM HOSPICE OF OKLAHOMA CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-13",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "763-464-0717"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4212",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OKLAHOMA LICENSE",
            "identifier": "371660",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "HO4212",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Journey Hospice, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.