NPIMap

Organization Active NPI

Heartland Hospice Services LLC

Doing business as ProMedica Hospice (Northfield)

  • Community Based Hospice Care Agency
  • Laurel Springs, NJ
National Provider Identifier
1396798112
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
22925 Issued in NJ
Legal business name
HEARTLAND HOSPICE SERVICES LLC
Doing business as
ProMedica Hospice (Northfield)
ProMedica Hospice (Woodbury)
Practice address
1385 Chews Land-Clem Road
Unit 4
Laurel Springs, NJ 08021
Phone
(856) 251-0707
Fax
(856) 251-9937
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Mr. Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Community Based Hospice Care Agency 251G00000X 22925 NJ Primary

Addresses

Primary practice location

1385 Chews Land-Clem Road
Unit 4
Laurel Springs, NJ 08021

Mailing address

333 N Summit St
Attn: Dean Shipman
Toledo, OH 43604-2615
Phone (419) 254-7841

Other practice location 1

2111 New Rd Ste 100
Northfield, NJ 08225-1512
Phone (609) 641-4675

Other identifiers 2

IdentifierTypeStateIssuer
0058572MedicaidNJ
8739200MedicaidNJ

Other names 2

  • ProMedica Hospice (Northfield) Doing business as
  • ProMedica Hospice (Woodbury) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200622002854 NJ Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 4 practitioners
3 other NPIs on this enrollment
Practice locations: Laurel Springs, NJ; Northfield, NJ

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

190 N Evergreen Ave
Ste 122
Woodbury, NJ 08096
Phone (856) 251-0707

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
Martin D Allen Individual Corporate DirectorDirector Sep 30, 2012
Operational/Managerial ControlChain Home Office Administrator Sep 22, 2017
HCR Manor Care Services LLC Organization, Toledo, OH Non-profit Operational/Managerial Control Dec 21, 2007
HCR Healthcare, LLC Organization, Toledo, OH 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 Sep 30, 2012
Justin Skiver Individual Corporate OfficerPresident Aug 29, 2023
Andrea Sype Individual Corporate OfficerVice President Jan 1, 2021
HCR Manorcare, Inc. Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%
HCR Home Health Care and Hospice LLC Organization, Toledo, OH Non-profit 5% Or Greater Direct Ownership Interest Dec 21, 2007 100%
Timothy Roberts Individual Corporate OfficerTreasurer Aug 31, 2021
Eric J Talbert Individual Corporate OfficerAssistant Vice President Jun 24, 2013
Christopher Bowen Individual Contracted Managing EmployeeAdministrator Aug 1, 2023
Damian Rodgers Individual Corporate OfficerSecretary Aug 14, 2020
Promedica Health System Inc Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1396798112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "ATTN: DEAN SHIPMAN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 CHEWS LAND-CLEM ROAD",
            "address_2": "UNIT 4",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "08021",
            "telephone_number": "856-251-0707",
            "fax_number": "856-251-9937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 New Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Northfield",
            "state": "NJ",
            "postal_code": "082251512",
            "country_code": "US",
            "telephone_number": "609-641-4675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NJ",
            "license": "22925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0058572",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8739200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Northfield)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Northfield)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Woodbury)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel Springs, NJ

Sources for this page

Verify at the official NPI Registry.