NPIMap

Organization Active NPI

Ella E M Brown Charitable Circle

  • Community Based Hospice Care Agency
  • Marshall, MI
National Provider Identifier
1407015019
Registry record updated Jan 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ELLA E M BROWN CHARITABLE CIRCLE
Practice address
13444 Preston Dr
Marshall, MI 49068-8536
Phone
(269) 789-3939
Fax
(269) 781-1120
NPI assigned
Jun 9, 2008
Last updated
Jan 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2018

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

Authorized official

Name
Adrienne Solis-Sherman, MSN, RN, CHPN
Title
Director
Phone
(269) 789-3939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

13444 Preston Dr
Marshall, MI 49068-8536

Mailing address

13444 Preston Dr
Marshall, MI 49068-8536
Phone (269) 789-3939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080721000251 MI Part A Provider - Hospice 1254228745 Practice locations: Marshall, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407015019. Details of each certification follow.

Hospice certification: CCN 231612

Legal name
ELLA E M BROWN CHARITABLE CIRCLE
Doing business as
OAKLAWN HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 14, 2009
Last certification
Jul 15, 2009
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Jul 27, 1912 in MI
Enrollment address
13444 Preston Dr
Marshall, MI 49068-8536

Other NPIs with the same Medicare PAC ID 5

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Oaklawn HospiceCCN 231612 · All quality measures
Ownership
Other
Certified
Jul 14, 2009
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ella E M Brown Charitable Circle9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

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.

NameRoleSinceShare
Randall Davis Individual Corporate Director Jun 23, 2017
Joseph Palchak Individual Corporate Director May 1, 2007
Theresa Dawson Individual W-2 Managing EmployeeChief Nursing Officer Mar 17, 2015
Thomas Neidlinger Individual Corporate Director Jan 1, 1999
Jack W Townsend Individual Corporate Director Mar 30, 2012
Carolle Hicks Individual W-2 Managing EmployeeAdministrator Oct 2, 2022
Derek King Individual Corporate Director Apr 28, 2017
Bruce Rasher Individual Corporate Director Jan 25, 2019
Gregg Beeg Individual Corporate OfficerPresident & Ceo Aug 4, 2018
W-2 Managing Employee Mar 30, 2014
Jaclyn S Liston-Crandall Individual Corporate Director Apr 18, 2021
Catherine Yates Individual Corporate Director Mar 27, 2015
Franklin Line Individual Corporate Director May 29, 2020
Mark Z Machalka Individual W-2 Managing EmployeeMedical Director Aug 29, 2016
Meghan Taft Individual Corporate Director Oct 28, 2022
Andrew Poole Individual Corporate OfficerChief Financial Officer Feb 1, 2019
W-2 Managing Employee Aug 4, 2018

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1407015019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13444 PRESTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688536",
            "telephone_number": "269-789-3939",
            "fax_number": "269-781-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13444 PRESTON DR",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490688536",
            "telephone_number": "269-789-3939",
            "fax_number": "269-781-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLA E M BROWN CHARITABLE CIRCLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "SOLIS-SHERMAN",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "269-789-3939",
        "authorized_official_credential": "MSN, RN, CHPN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

Verify at the official NPI Registry.