NPIMap

Organization Active NPI

Heartland Hospice Services, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Flint, MI
National Provider Identifier
1396480125
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Practice address
6211 Taylor Dr
Flint, MI 48507-4665
Phone
(810) 230-1318
NPI assigned
May 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Martin David Allen
Title
Sole Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

6211 Taylor Dr
Flint, MI 48507-4665

Mailing address

PO Box 10086
Toledo, OH 43699-0086
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
1436970MedicaidMI

Other names 1

  • ProMedica Hospice (Flint) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Terrence G Metzger Individual Corporate OfficerTreasurer Nov 1, 2023
Martin D Allen Individual Corporate DirectorSole Director Sep 30, 2012
Operational/Managerial ControlChain Home Office Administrator Sep 22, 2017
Amber Melancon Individual Contracted Managing EmployeeAdministrator Sep 30, 2019
HCR Manor Care Services LLC Organization, Toledo, OH LLC, For-profit Operational/Managerial Control Dec 21, 2007
HCR Healthcare, LLC Organization, Toledo, OH LLC, Non-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2007 100%
Dean Shipman Individual W-2 Managing EmployeeAvp Reimbursement Services May 1, 2016
Kathryn H Hoops Individual Corporate OfficerVice President Nov 7, 2007
Stephen M Sadowski Individual Corporate OfficerSecretary Nov 1, 2023
Justin Skiver Individual Corporate OfficerPresident Aug 29, 2023
Andrea Sype Individual Corporate OfficerVice President Jan 1, 2021
HCR Manorcare, Inc. Organization, Toledo, OH Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%
HCR Home Health Care and Hospice LLC Organization, Toledo, OH LLC, Non-profit 5% Or Greater Direct Ownership Interest Dec 21, 2007 100%
Eric J Talbert Individual Corporate OfficerAssistant Vice President Jun 24, 2013
Promedica Health System Inc Organization, Toledo, OH Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1396480125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6211 TAYLOR DR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485074665",
            "telephone_number": "810-230-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1436970",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Flint)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.