Organization Active NPI

Heartland Home Care, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Roanoke, VA
National Provider Identifier
1497490205
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOME CARE, LLC
Practice address
2840 Electric Rd Ste 106a
Roanoke, VA 24018-3551
Phone
(540) 725-7600
NPI assigned
May 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Martin David Allen
Title
Sole Director
Phone
(419) 252-5734

Specialties & licenses 1

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

Addresses

Primary practice location

2840 Electric Rd Ste 106a
Roanoke, VA 24018-3551

Mailing address

PO Box 10086
Toledo, OH 43699-0086
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
1629470745MedicaidVA

Other names 1

  • ProMedica Hospice (Roanoke) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191206000039 VA Part B Supplier - Clinic/Group Practice 4789592817 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lynchburg, VA; Roanoke, VA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Heartland Home Care LLC4 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.

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations (25 of 33)

3657 Cortez Rd W
Ste 100
Bradenton, FL 34210
Phone (941) 744-1101

628 N Indiana Ave
Englewood, FL 34223
Phone (941) 473-1519

1469 Colonial Blvd
Ste 201
Fort Myers, FL 33907
Phone (239) 437-0909

1400 Colonial Blvd
Ste 65
Fort Myers, FL 33907
Phone (239) 437-0909

20646 Abbey Woods Ct N
Ste 305
Frankfort, IL 60423
Phone (815) 806-1000

3210 W Kellogg Dr
Wichita, KS 67213
Phone (316) 788-7626

3243 E Murdock St
Wichita, KS 67208
Phone (316) 500-8900

12304 Baltimore Ave
Ste A
Beltsville, MD 20705
Phone (240) 264-1690

8201 Corporate Dr
Ste 120
Landover, MD 20785
Phone (301) 731-4356

3840 Packard St
Ste 240
Ann Arbor, MI 48108
Phone (734) 677-8140

630 N State St
Caro, MI 48723
Phone (989) 672-0445

4125 Embassy Dr SE
Grand Rapids, MI 49546
Phone (616) 956-0636

500 Cascade West Pkwy SE
Grand Rapids, MI 49546
Phone (616) 956-5585

1212 S Telegraph Rd
Ste G
Monroe, MI 48161
Phone (734) 242-1320

2074 S Custer Rd
Monroe, MI 48161
Phone (734) 242-1320

6500 Busch Blvd
Ste 210
Columbus, OH 43229
Phone (614) 433-0423

3131 S Dixie Dr
#221
Moraine, OH 45439
Phone (937) 297-0548

107 Howard St
Mount Vernon, OH 43050
Phone (740) 392-1450

1507 W Main St
Newark, OH 43055
Phone (740) 322-6070

35 Bierly Rd
Ste 2
Portsmouth, OH 45662
Phone (740) 353-0423

3521 E Jackson St
Ste B
Hugo, OK 74743
Phone (580) 326-7353

1100 N Porter Ave
Ste 104
Norman, OK 73071
Phone (405) 307-9814

11212 N May Ave
Ste 110
Oklahoma City, OK 73120

5800 E Skelly Dr
Ste 500
Tulsa, OK 74135
Phone (918) 270-4628

1200 Walnut Bottom Rd
Ste 302
Carlisle, PA 17015
Phone (717) 240-0018

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1497490205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 ELECTRIC RD STE 106A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183551",
            "telephone_number": "540-725-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629470745",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Roanoke)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.