Organization Active NPI

Ascent Hospice LLC

  • Community Based Hospice Care Agency
  • South Bend, IN
National Provider Identifier
1427700574
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
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

Updated by the provider on Jan 24, 2022

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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
LLCProprietary
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 LLCCCN 151649
Certified
Sep 22, 2022
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2253100Ascent Hospice, LLC1930 Edison Rd, South Bend, IN 46617Certificate of waiverFeb 16, 2028

National Provider Directory

National Provider Directory

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.

NameRoleSinceShare
Kevin W Clem Individual 5% Or Greater Direct Ownership Interest Mar 16, 2022
Corporate DirectorAdministrator Mar 2, 2022
Operational/Managerial ControlOwner Mar 16, 2021 100%
Abigail M Battjes Individual Contracted Managing EmployeeMD; 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.

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

Verify at the official NPI Registry.