NPIMap

Organization Active NPI

Lifecare Hospice

  • Community Based Hospice Care Agency
  • Wooster, OH
National Provider Identifier
1477540284
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
0033HSP Issued in OH
Legal business name
LIFECARE HOSPICE
Practice address
1900 Akron Rd
Wooster, OH 44691-2518
Phone
(330) 264-4899
Fax
(330) 264-4874
NPI assigned
Oct 6, 2005
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFECARE HOSPICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Mr. Kurt Holmes
Title
Executive Director
Phone
(330) 264-4899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 0033HSP OH Primary

Addresses

Primary practice location

1900 Akron Rd
Wooster, OH 44691-2518

Mailing address

1900 Akron Rd
Wooster, OH 44691-2518
Phone (330) 264-4899

Other identifiers 1

IdentifierTypeStateIssuer
0795448MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120305000369 OH Part A Provider - Hospice 1052395571 Practice locations: Millersburg, OH; New Philadelphia, OH; Wooster, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477540284. Details of each certification follow.

Hospice certification: CCN 361544

Legal name
LIFECARE HOSPICE
Doing business as
OHIO'S HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 14, 1990
Last certification
Jan 30, 2020
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1980 in OH
Enrollment address
1900 Akron Road
Wooster, OH 44691-2518

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Lifecare HospiceCCN 361544 · All quality measures
Ownership
Non-Profit
Certified
May 14, 1990
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Lifecare Hospice

Locations

201 School Dr
Loudonville, OH 44842
Phone (419) 994-5405

747 S Mount Vernon Ave
Loudonville, OH 44842
Phone (419) 994-0724

1263 Glen Dr
Millersburg, OH 44654

1263 Glen Dr
#B
Millersburg, OH 44654
Phone (330) 264-4899

1633 S Washington St
Millersburg, OH 44654
Phone (330) 264-4899

1900 Akron Rd
Ste 1
Wooster, OH 44691

2525 Back Orrville Rd
Wooster, OH 44691
Phone (330) 264-4899

4138 Swanson Blvd
Wooster, OH 44691
Phone (330) 345-9050

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Jodi Lynn Hannan Individual Corporate DirectorJodi Hannan MD Medical Director Jan 1, 2021
W-2 Managing EmployeeMD; Jan 1, 2021
Kent Anderson Individual Corporate OfficerChief Executive Officer Nov 1, 2023
W-2 Managing Employee Nov 1, 2023
Operational/Managerial ControlChief Executive Officer Nov 1, 2023
Renee Sparks Individual W-2 Managing EmployeeAd; Jan 1, 2025
Ginger Preston Individual Corporate DirectorGinger Preston Dir Comp Inpt SVC Jul 13, 2016
Kurt Holmes Individual Corporate DirectorExe Dir Feb 15, 2017 100%
Deborah Meadows Individual Corporate DirectorDeborah Meadows Dir Clin Svces Jul 13, 2016
Ohio's Hospice Inc. Organization, Dayton, OH Corporation, Non-profit Operational/Managerial Control Jun 29, 2017 100%

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 2

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

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

Affiliated clinicians 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1477540284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 AKRON RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912518",
            "telephone_number": "330-264-4899",
            "fax_number": "330-264-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 AKRON RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912518",
            "telephone_number": "330-264-4899",
            "fax_number": "330-264-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE HOSPICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFECARE HOSPICE",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "330-264-4899",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OH",
            "license": "0033HSP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0795448",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.