Viaquest Hospice of Indiana, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

003308 Issued in IN

Legal business name

VIAQUEST HOSPICE OF INDIANA, LLC

Doing business as

Serenity Hospice

Practice address

5 N 10TH St
Lafayette, IN 47901-1595

Phone

(765) 446-9100

Fax

(765) 884-7001

NPI assigned

Dec 5, 2006

Last updated

Nov 25, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Johnson

Title

President

Phone

(614) 339-0820

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Serenity Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1467510198. Details of each certification follow.

• CCN 151575 Hospice · Active · Details

Hospice certification: CCN 151575

Legal name

VIAQUEST HOSPICE OF INDIANA, LLC

Doing business as

VIAQUEST, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 30, 2002

Last certification

Apr 19, 2018

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Enrollment address

724 W Navajo St
West Lafayette, IN 47906-1966

Listed as

Viaquest Hospice of Indiana, LLCCCN 151575 · All quality measures

Ownership

For-Profit

Certified

Aug 30, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Serenity Hospice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Viaquest Hospice of Indiana, LLV

  • Community Based Hospice Care Agency
  • Lafayette, IN
  • NPI 1609292978
  NPD tax ID

Locations

All disclosed owners & managing parties 4

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

Facilities with the same owner 2

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

• Viaquest Hospice LLC

  • Community Based Hospice Care Agency
  • Cincinnati, OH
  • NPI 1346405370

  Capstone Holdings, LLC, Viaquest Hospice Holdings, LLC

  CMS ownership
• Viaquest Hospice, LLC

  • Community Based Hospice Care Agency
  • Dublin, OH
  • NPI 1568715464

  Viaquest Hospice Holdings, LLC

  CMS ownership

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Robert W Anderson, MD

  • Internal Medicine Physician
  • Anderson, IN
  • NPI 1790851509

  Hospice

  Care Compare affiliation
• William Eric Heath, MD

  • Family Medicine Physician
  • Sullivan, IN
  • NPI 1942203104

  Hospice

  Care Compare affiliation
• Jeffrey B Hiltz, MD

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1568437572

  Hospice

  Care Compare affiliation
• Derek Parkes, M.D.

  • Family Medicine Physician
  • Linton, IN
  • NPI 1205246790

  Hospice

  Care Compare affiliation
• Sheryar Sarwar, MD

  • Family Medicine Physician
  • Kokomo, IN
  • NPI 1730426958

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416873600000",
    "number": "1467510198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "614-339-0814",
            "fax_number": "614-339-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 N 10TH ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479011595",
            "telephone_number": "765-446-9100",
            "fax_number": "765-884-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIAQUEST HOSPICE OF INDIANA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2014-11-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-339-0820"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "IN",
            "license": "003308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201056830",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissa Vaughn
• Sarah Vaught
• Praveen Venigalla
• Dagmara Ventresca, DDS
• Via Quest Home Health of Indiana, LLC (Mulberry Community Health Services)
• Viaquest Hospice of Indiana, LLV
• Vibrant Dental LLC
• Prasert Vijitbenjaronk, M.D.
• Justin Villanueva, DMD, MSD, DHL
• Venkata Vindhyamuri

• Community Based Hospice Care Agency in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Community Based Hospice Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2014; 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.

Verify at the official NPI Registry.