NPIMap

Organization Active NPI

Bristol Palliative Care Services, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1467930552
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
BRISTOL PALLIATIVE CARE SERVICES, LLC
Practice address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone
(801) 325-0175
Fax
(801) 478-3588
NPI assigned
Aug 1, 2018
Organization subpart
Yes
Parent organization
BRISTOL HOSPICE, L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Melissa Broadway
Title
Chief Clinical Officer
Phone
(801) 930-5266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741

Mailing address

206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 930-5266

Other practice location 1

55 Merchant St Ste 2900
Honolulu, HI 96813-4384
Phone (808) 650-2077

Other practice location 2

5210 E Williams Cir Ste 530
Tucson, AZ 85711-4459
Phone (520) 300-9337

Other practice location 3

1634 Highway 531
Minden, LA 71055-6530
Phone (225) 329-1550

Other practice location 4

1106 E 6600 S Ste 100
Murray, UT 84121-2446
Phone (801) 930-5266

Other names 1

  • Bristol Advanced Illness Management Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, HI, AZ, LA4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20190624003050 UT Part B Supplier - Clinic/Group Practice 6507190626 Receives reassigned benefits from 3 practitioners
Practice locations: Salt Lake City, UT
O20190919003107 HI Part B Supplier - Clinic/Group Practice 6507190626 Receives reassigned benefits from 18 practitioners
Practice locations: Honolulu, HI
O20220727003640 AZ Part B Supplier - Clinic/Group Practice 6507190626 Receives reassigned benefits from 4 practitioners
Practice locations: Tucson, AZ
O20230118002282 LA Part B Supplier - Clinic/Group Practice 6507190626 Receives reassigned benefits from 2 practitioners
Practice locations: Minden, LA

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
03D2332621Bristol Palliative Care Services LLC Dba5210 E Williams Circle Ste 722, Tucson, AZ 85711Certificate of waiverOct 21, 2027
46D2190755Bristol Palliative Care LLC1106 East 6600 South Ste 100, Murray, UT 84121Certificate of waiverAug 18, 2026

National Provider Directory

National Provider Directory
Part of
Bristol Hospice LLC

Locations

5210 E Williams Cir
Tucson, AZ 85711

1634 Highway 531
Minden, LA 71055
Phone (225) 329-1550

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1467930552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-930-5266",
            "fax_number": "801-930-5272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N 2100 W STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841164741",
            "telephone_number": "801-325-0175",
            "fax_number": "801-478-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Merchant St Ste 2900",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968134384",
            "country_code": "US",
            "telephone_number": "808-650-2077",
            "fax_number": "808-441-1919",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5210 E Williams Cir Ste 530",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857114459",
            "country_code": "US",
            "telephone_number": "520-300-9337",
            "fax_number": "520-300-8073",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1634 Highway 531",
            "address_purpose": "LOCATION",
            "city": "Minden",
            "state": "LA",
            "postal_code": "710556530",
            "country_code": "US",
            "telephone_number": "225-329-1550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1106 E 6600 S Ste 100",
            "address_purpose": "LOCATION",
            "city": "Murray",
            "state": "UT",
            "postal_code": "841212446",
            "country_code": "US",
            "telephone_number": "801-930-5266",
            "fax_number": "801-327-7064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRISTOL PALLIATIVE CARE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
        "enumeration_date": "2018-08-01",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "BROADWAY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "801-930-5266"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bristol Advanced Illness Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.