Emerald First Choice Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

EMERALD FIRST CHOICE HOSPICE LLC

Doing business as

Emerald Hospice II

Practice address

120 S Yorkshire Blvd
Wagoner, OK 74467

Phone

(918) 485-0079

Fax

(918) 485-0017

NPI assigned

Aug 2, 2010

Last updated

Feb 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Wilkey

Title

Director of Operations

Phone

(918) 485-0079

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Emerald Hospice II Doing business as

Medicare fee-for-service enrollment

Enrolled in OK2 enrollments

Enrollment records 2

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386958312. Details of each certification follow.

• CCN 371697 Hospice · Active · Details

Hospice certification: CCN 371697

Legal name

EMERALD FIRST CHOICE HOSPICE LLC

Doing business as

EMERALD HOSPICE II

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 9, 2011

Last certification

Aug 6, 2020

Ownership / control type

Proprietary - Partnership

Organization structure

LLCProprietary

Incorporated

Nov 28, 2017 in OK

Enrollment address

120 S Yorkshire Blvd
Wagoner, OK 74467-4861

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Emerald First Choice Hospice LLC

  dba Emerald Hospice I

  • Community Based Hospice Care Agency
  • Edmond, OK
  • NPI 1548691645

  3678834017

  Same PAC ID

Listed as

Emerald Hospice IICCN 371697 · All quality measures

Ownership

For-Profit

Certified

Sep 9, 2011

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Emerald First Choice Hospice LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Emerald First Choice Hospice LLC

  dba Emerald Hospice I

  • Community Based Hospice Care Agency
  • Edmond, OK
  • NPI 1548691645
  NPD tax ID

Locations

All disclosed owners & managing parties 15

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

Owners & managing parties with NPI records 1

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

• Jack Howard Brown Jr., MD, DPM

  • Family Medicine Physician
  • Sand Springs, OK
  • NPI 1982699096

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 1

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

• Emerald First Choice Hospice LLC

  dba Emerald Hospice I

  • Community Based Hospice Care Agency
  • Edmond, OK
  • NPI 1548691645

  Emerald Hospice LLC, First Choice Hospice LLC, Jim Hospice LLC, Palm Tree Hospice LLC, Rosewood Hospice LLC, Z Capital Oklahoma LLC

  CMS ownership

Change-of-ownership history 3

Change of ownership 1

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

• Emerald First Choice Hospice LLC

  dba Emerald Hospice I

  • Community Based Hospice Care Agency
  • Edmond, OK
  • NPI 1548691645

  Sold to, 2018-01-01

  CMS change of ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jillian Ross Riley, DO

  • Family Medicine Physician
  • Muskogee, OK
  • NPI 1619153574
  Medicare reassignment NPD

Affiliated clinicians 2

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

• Jack Howard Brown Jr., MD, DPM

  • Family Medicine Physician
  • Sand Springs, OK
  • NPI 1982699096

  Hospice

  Care Compare affiliation
• Jillian Ross Riley, DO

  • Family Medicine Physician
  • Muskogee, OK
  • NPI 1619153574

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1386958312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 S YORKSHIRE BLVD",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744674861",
            "telephone_number": "918-485-0079",
            "fax_number": "918-485-0017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 S YORKSHIRE BLVD",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "74467",
            "telephone_number": "918-485-0079",
            "fax_number": "918-485-0017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD FIRST CHOICE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "WILKEY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "918-485-0079"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200537500A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emerald Hospice II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emerald Hospice II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eagle Ridge Institute
• Eagle Ridge Institute
• Ashley Ann Edwards
• Cortez De'Angelo Edwards
• Melissa Ellis
• Jeffrey K Evans, MD
• Mylinda Renee Fanj, M.S., LPC (US)
• Elizabeth Farar
• Farmer Family Practice
• Jennifer Anne Farmer, ARNP-CNP

• Community Based Hospice Care Agency in Wagoner, OK
• Providers in Wagoner, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.