NPIMap

Organization Active NPI

Heartland Hospice Services, LLC

Doing business as ProMedica Hospice (Cleveland)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Independence, OH
National Provider Identifier
1437865177
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Doing business as
ProMedica Hospice (Cleveland)
Practice address
4807 Rockside Rd Ste 110
Independence, OH 44131-2140
Phone
(216) 520-0765
NPI assigned
Jan 26, 2023
Last updated
Jan 26, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND HOSPICE SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Authorized official

Name
Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

4807 Rockside Rd Ste 110
Independence, OH 44131-2140

Mailing address

333 N Summit St
Toledo, OH 43604-1531
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
2207365MedicaidOH

Other names 1

  • ProMedica Hospice (Cleveland) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200623001943 OH Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 4 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbus, OH; Washington Court House, OH; Sidney, OH; Marion, OH; Lucasville, OH; Kettering, OH; Jackson, OH; Independence, OH…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Heartland Hospice SVCS LLC

Locations

4807 Rockside Rd
Ste 110
Independence, OH 44131
Phone (216) 520-0765

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1437865177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4807 ROCKSIDE RD STE 110",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312140",
            "telephone_number": "216-520-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207365",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Cleveland)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.