NPIMap

Organization Active NPI

Maple Creek Hospice Inc

  • Community Based Hospice Care Agency
  • Sparta, IL
National Provider Identifier
1477007458
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MAPLE CREEK HOSPICE INC
Practice address
110 S Market St
Sparta, IL 62286-2062
Phone
(618) 443-4671
NPI assigned
Aug 8, 2016
Last updated
Dec 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Kalyn Noel Glodo
Title
Administrator
Phone
(618) 443-4671

Specialties & licenses 1

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

Addresses

Primary practice location

110 S Market St
Sparta, IL 62286-2062

Mailing address

301 Sovereign CT
Ballwin, MO 63011-4441
Phone (314) 631-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180703000416 IL Part A Provider - Hospice 1658627740 Practice locations: Sparta, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477007458. Details of each certification follow.

Hospice certification: CCN 141698

Legal name
MAPLE CREEK HOSPICE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 22, 2018
Last certification
Dec 29, 2021
Ownership / control type
Other
Organization structure
CorporationProprietary
Incorporated
Sep 15, 2016 in IL
Enrollment address
110 S Market St
Sparta, IL 62286-2062

Care Compare: Hospice

Medicare Care Compare
Listed as
Maple Creek Hospice IncCCN 141698 · All quality measures
Ownership
For-Profit
Certified
Oct 22, 2018
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

110 S Market St
Sparta, IL 62286
Phone (618) 443-4524

706 S Saint Louis St
Sparta, IL 62286
Phone (618) 443-4671

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
James R Kirkpatrick Individual Contracted Managing EmployeeMD; Feb 23, 2024
Yosef Manne Individual 5% Or Greater Indirect Ownership InterestCeo Feb 23, 2024 10%
Kayln Glodo Individual W-2 Managing EmployeeAd; Feb 23, 2024
Naftali Friedman Individual 5% Or Greater Indirect Ownership InterestCfo Feb 23, 2024 5%
Chaim Dov Winter Individual 5% Or Greater Indirect Ownership InterestCoo Feb 23, 2024 5%
Il Hospice Investments, LLC Organization, Ballwin, MO Created for acquisition, LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 23, 2024 100%
10-26 Nationwide TR Organization, Lakewood, NJ Created for acquisition 5% Or Greater Indirect Ownership Interest Feb 23, 2024 37.5%
Menachem Winter Individual 5% Or Greater Indirect Ownership InterestGeneral Counsel Feb 23, 2024 5%
Judah Bienstock Individual 5% Or Greater Indirect Ownership InterestCeo Feb 23, 2024 37.5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 39

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

View all 39

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": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1477007458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114441",
            "telephone_number": "314-631-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S MARKET ST",
            "city": "SPARTA",
            "state": "IL",
            "postal_code": "622862062",
            "telephone_number": "618-443-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE CREEK HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "GLODO",
        "authorized_official_first_name": "KALYN",
        "authorized_official_middle_name": "NOEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-443-4671"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, IL

Sources for this page

Verify at the official NPI Registry.