Active NPI
Ascent Hospice LLC
- Community Based Hospice Care Agency
- South Bend, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- ASCENT HOSPICE LLC
- Practice address
- 1930 Edison Rd
South Bend, IN 46617-1711 - Phone
- (574) 213-2727
- NPI assigned
- Jan 20, 2022
- 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 Clem
- Title
- Owner
- Phone
- (801) 403-7917
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1930 Edison Rd
South Bend, IN 46617-1711
Mailing address
1930 Edison Rd
South Bend, IN 46617-1711
Phone (574) 213-2727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220810003584 | IN | Part A Provider - Hospice | 3678956554 | Practice locations: South Bend, IN |
Hospice certification: CCN 151649
- Legal name
- ASCENT HOSPICE LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 22, 2022
- Last certification
- Sep 22, 2022
- Organization structure
- LLC
- Incorporated
- Mar 16, 2021 in IN
- Enrollment address
- 1930 Edison Rd
South Bend, IN 46617-1711
Care Compare: Hospice
Medicare Care Compare- Listed as
- Ascent Hospice LLC
- Certified
- Sep 22, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2253100 | Ascent Hospice, LLC | Certificate of waiver | Feb 16, 2028 |
National Provider Directory
National Provider DirectoryOwnership & 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 W Clem | 5% Or Greater Direct Ownership Interest | Mar 16, 2022 | |
| Corporate Director | Mar 2, 2022 | ||
| Operational/Managerial Control | Mar 16, 2021 | 100% | |
| Abigail M Battjes | Contracted Managing Employee | Aug 8, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- South Bend, IN
- NPI 1336400167
Contracted Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 2
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": "1642636800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1642982400000",
"number": "1427700574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 EDISON RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466171711",
"telephone_number": "574-213-2727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 EDISON RD",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466171711",
"telephone_number": "574-213-2727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ASCENT HOSPICE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-01-20",
"last_updated": "2022-01-24",
"certification_date": "2022-01-24",
"status": "A",
"authorized_official_last_name": "CLEM",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "801-403-7917"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.