NPIMap

Organization Active NPI

Three Rivers Hospice, Inc.

Doing business as Three Rivers Hospice Central

  • Community Based Hospice Care Agency
  • Jefferson City, MO
National Provider Identifier
1457927337
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
THREE RIVERS HOSPICE, INC.
Doing business as
Three Rivers Hospice Central
Practice address
3236 Emerald Lane
Suite 400
Jefferson City, MO 65109
Phone
(573) 635-8084
Fax
(573) 636-0176
NPI assigned
Jun 1, 2021
Last updated
Jun 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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

Authorized official

Name
Donald B. Bedell
Title
President
Phone
(573) 471-1276

Specialties & licenses 1

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

Addresses

Primary practice location

3236 Emerald Lane
Suite 400
Jefferson City, MO 65109

Mailing address

PO Box 1210
731 N Main Street
Sikeston, MO 63801-1210
Phone (573) 635-8084

Other names 1

  • Three Rivers Hospice Central Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210628002745 MO Part A Provider - Hospice 1557370459 Practice locations: Jefferson City, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457927337. Details of each certification follow.

Hospice certification: CCN 261692

Legal name
THREE RIVERS HOSPICE INC
Doing business as
THREE RIVERS HOSPICE CENTRAL
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 13, 2021
Last certification
Dec 13, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Sep 30, 2004 in MO
Enrollment address
3236 Emerald LN
Ste 400
Jefferson City, MO 65109-3700

Other NPIs with the same Medicare PAC ID 3

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Three Rivers Hospice CentralCCN 261692 · All quality measures
Ownership
For-Profit
Certified
Dec 13, 2021
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
26D2227818Three Rivers Hospice Central3236 Emerald LN, Ste 400, Jefferson City, MO 65109Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Three Rivers Hospice Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

423 Shawnee St
Leavenworth, KS 66048
Phone (913) 297-0578

1604 NW Mock Ave
Ste C
Blue Springs, MO 64015
Phone (816) 295-0544

202 SW 10th St
Blue Springs, MO 64015
Phone (816) 295-0544

2307 NW South Outer Rd
Ste 103
Blue Springs, MO 64015
Phone (816) 295-0544

2307 S Outer Rd
#102
Blue Springs, MO 64015
Phone (816) 295-0544

500 Lana Dr
Cameron, MO 64429
Phone (816) 632-2910

607 Lana Dr
Ste A
Cameron, MO 64429
Phone (816) 632-2910

101 Main St
Ste 4
Cassville, MO 65625
Phone (471) 541-0370

3236 Emerald Ln
Ste 400
Jefferson City, MO 65109
Phone (573) 635-8084

3338 NE Ralph Powell Rd
Ste C
Lees Summit, MO 64064
Phone (816) 295-0544

217 N Highway 63
Licking, MO 65542
Phone (573) 674-1127

105 E 2nd St
Mountain Grove, MO 65711
Phone (417) 926-3373

1902 W 19th St
Ste E
Mountain Grove, MO 65711
Phone (417) 926-3373

301 E 17th St
Mountain Grove, MO 65711
Phone (417) 926-3373

8403 Outer Rd
Mountain Grove, MO 65711
Phone (417) 926-3373

220 Main St
Platte City, MO 64079
Phone (816) 431-2333

700 Branch St
Ste 4
Platte City, MO 64079
Phone (816) 431-2333

1329 Village Dr
Saint Joseph, MO 64506
Phone (816) 279-8600

2335 N Belt Hwy
Saint Joseph, MO 64506
Phone (613) 279-8600

3901 Beck Rd
Ste C
Saint Joseph, MO 64506
Phone (816) 279-8600

625 E Russell Ave
Ste A
Warrensburg, MO 64093
Phone (816) 431-2333

801 Porter Wagoner Blvd
West Plains, MO 65775
Phone (417) 255-1560

901 W Broadway St
West Plains, MO 65775
Phone (417) 255-1560

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Anita Wade Individual Corporate OfficerDirector of Medicare Billing Dec 1, 2022
Circle B Enterprises Holding Company Inc Organization, Sikeston, MO Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Apr 13, 2021 100%
Todd Beaird Individual Corporate OfficerCfo Jan 1, 2022
Donald B Bedell Individual Corporate OfficerPresident Nov 1, 2014
Corporate DirectorPresident Sep 30, 2004
Denielle Hawkins Individual W-2 Managing EmployeeAdministrator Jun 15, 2022

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1622505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1457927337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1210",
            "address_2": "731 N MAIN STREET",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638011210",
            "telephone_number": "573-635-8084",
            "fax_number": "573-472-8504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 EMERALD LANE",
            "address_2": "SUITE 400",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-635-8084",
            "fax_number": "573-636-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "BEDELL",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-471-1276"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Hospice Central",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.