Active NPI
Penn Hospice, Inc.
- Community Based Hospice Care Agency
- Ebensburg, PA
National Provider Identifier
1427426709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 17761601
- Legal business name
- PENN HOSPICE, INC.
- Practice address
- 313 W High St
Suite 210
Ebensburg, PA 15931-1549 - Phone
- (814) 846-4160
- Fax
- (814) 419-8218
- NPI assigned
- Sep 3, 2015
- Last updated
- Jun 28, 2019
- 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
- Kevin Carter Deyarmin
- Title
- Chief Operating Officer
- Phone
- (814) 846-4160
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 17761601 | PA | Primary |
Addresses
Primary practice location
313 W High St
Suite 210
Ebensburg, PA 15931-1549
Mailing address
313 W High St
Suite 210
Ebensburg, PA 15931-1549
Phone (814) 846-4160
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20151030001141 | PA | Part A Provider - Hospice | 7517277759 | Practice locations: Ebensburg, PA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1427426709. Details of each certification follow.
Hospice certification: CCN 391776
- Legal name
- PENN HOSPICE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Mar 23, 2016
- Last certification
- Mar 24, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Dec 18, 2013 in PA
- Enrollment address
- 313W High St 210
Ebensburg, PA 15931-1549
Care Compare: Hospice
Medicare Care Compare- Listed as
- Penn Hospice, Inc
- Ownership
- For-Profit
- Certified
- Mar 23, 2016
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
313 W High St
Ste 210
Ebensburg, PA 15931
Phone (704) 269-8933
Ownership & related parties
All disclosed owners & managing parties 2
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 |
|---|---|---|---|
| Kevin C Deyarmin | W-2 Managing Employee | Sep 3, 2015 | |
| Frank a Rezk | 5% Or Greater Direct Ownership Interest | Dec 18, 2013 | 100% |
| Corporate Officer | Dec 21, 2013 | ||
| Corporate Director | Dec 21, 2013 | ||
| Operational/Managerial Control | Dec 21, 2013 |
Practitioners & affiliated clinicians
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.
-
- Naturopath
- South Fork, PA
- NPI 1063940773
Affiliated clinicians 14
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": "1441238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1561680000000",
"number": "1427426709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "313 W HIGH ST",
"address_2": "SUITE 210",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159311549",
"telephone_number": "814-846-4160",
"fax_number": "814-419-8218"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "313 W HIGH ST",
"address_2": "SUITE 210",
"city": "EBENSBURG",
"state": "PA",
"postal_code": "159311549",
"telephone_number": "814-846-4160",
"fax_number": "814-419-8218"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PENN HOSPICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-03",
"last_updated": "2019-06-28",
"status": "A",
"authorized_official_last_name": "DEYARMIN",
"authorized_official_first_name": "KEVIN",
"authorized_official_middle_name": "CARTER",
"authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
"authorized_official_telephone_number": "814-846-4160"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "PA",
"license": "17761601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ebensburg, PA
- Joseph Ozbold, O.D.
- John Lewis Parcell, RN
- Heather Nicole Park, DPT
- Kristen Pasierb, DPT
- Valerie Leah Pattillo, R.N
- Lawrence Pennington, LPC
- Pennsylvania Department of Human Services (Ebensburg Center)
- Pennsylvania Department of Public Welfare (Ebensburg Center Pharmacy)
- Kathy Jo Peno, OTR/L
- Liza Perez, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.