Active NPI
Hubbard Hill Estates, Inc.
- Skilled Nursing Facility
- Elkhart, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 06-001131-1
- Legal business name
- HUBBARD HILL ESTATES, INC.
- Practice address
- 28070 County Road 24
Elkhart, IN 46517-9774 - Phone
- (574) 295-6260
- Fax
- (574) 295-5852
- NPI assigned
- Sep 28, 2006
- Last updated
- Mar 31, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Patrick Pingel
- Title
- Executive Director
- Phone
- (574) 295-6260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 06-001131-1 | IN | Primary |
Addresses
Primary practice location
28070 County Road 24
Elkhart, IN 46517-9774
Mailing address
28070 County Road 24
Elkhart, IN 46517-9774
Phone (574) 295-6260
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200823940A | Medicaid | IN | |
| 000000493029 | Other | IN | ANTHEM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060404000352 | IN | Part A Provider - Skilled Nursing Facility | 5496763369 | Practice locations: Elkhart, IN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1396837639. Details of each certification follow.
Skilled nursing facility certification: CCN 155754
- Legal name
- HUBBARD HILL ESTATES, INC.
- Doing business as
- HUBBARD HILL ESTATES INC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 27, 2006
- Last certification
- Sep 10, 2024
- Beds
- 280 (66 certified)
- Ownership / control type
- Other Nonprofit
- Organization structure
- Corporation
- Incorporated
- Dec 2, 1975 in IN
- Enrollment address
- 28070 County Road 24
Elkhart, IN 46517-9717 - Nursing home name
- HUBBARD HILL ESTATES INC
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Hubbard Hill Estates Inc
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Other
- Certified
- Jul 27, 2006
- Medicare certification status
- Active
- Certified beds
- 66
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 10
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Deb Gillum | Corporate Director | Dec 11, 2017 | |
| Bruce Korenstra | Corporate Officer | Mar 10, 2014 | |
| Corporate Director | Apr 4, 2006 | ||
| Ron Clark | Corporate Director | Apr 4, 2006 | |
| Ronda Powell | Corporate Director | Sep 14, 2020 | |
| Patrick Pingel | Corporate Director | Nov 8, 2004 | |
| W-2 Managing Employee | Nov 8, 2004 | ||
| Joe Wenger | Corporate Officer | Mar 10, 2014 | |
| Corporate Director | Mar 10, 2014 | ||
| Doyle a Yeager | Corporate Director | Mar 14, 2016 | |
| Ken Fervida | Corporate Director | Sep 8, 2014 | |
| Gregory M Conrad | Corporate Director | Dec 9, 2019 | |
| Terry Schollmeier | W-2 Managing Employee | Mar 10, 2014 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Elkhart, IN
- NPI 1437126620
Corporate Director
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1396224000000",
"number": "1396837639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28070 COUNTY ROAD 24",
"city": "ELKHART",
"state": "IN",
"postal_code": "465179774",
"telephone_number": "574-295-6260",
"fax_number": "574-295-5852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28070 COUNTY ROAD 24",
"city": "ELKHART",
"state": "IN",
"postal_code": "465179774",
"telephone_number": "574-295-6260",
"fax_number": "574-295-5852"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HUBBARD HILL ESTATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-28",
"last_updated": "2014-03-31",
"status": "A",
"authorized_official_last_name": "PINGEL",
"authorized_official_first_name": "PATRICK",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "574-295-6260",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "IN",
"license": "06-001131-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200823940A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000493029",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkhart, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.