Hospice of Michigan, Inc.
Organization Active NPI Community Based Hospice Care Agency · Ada, MI
NPI 1508800418 · NPPES record last updated Nov 26, 2024
Key facts
- NPI
- 1508800418
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- HOSPICE OF MICHIGAN, INC.
- Practice address
- 989 Spaulding Ave SE
Ada, MI 49301-3701 - Phone
- (616) 454-1426
- NPI assigned
- Jun 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Lee Ann Myers
- Title
- Chief Administrative Officer
- Phone
- (734) 718-5037
Owners & managing parties with NPI records 4
Owned or controlled facilities with NPI records 4
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 3
Facilities with the same owner 4
Affiliated clinicians 3
-
Daniel Carrel, DO
-
Nathan Dills, DO
Medicare Care Compare: Hospice
- Listed as
- Hospice of Western Michigan
- Ownership
- Non-Profit
- Certified
- Aug 13, 1985
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2086549 | Hospice of Michigan, Inc | Certificate of waiver | Nov 5, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Hospice certification: CCN 231510
- Legal name
- HOSPICE OF MICHIGAN, INC.
- Doing business as
- HOSPICE OF WESTERN MICHIGAN, INC.
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 13, 1985
- Last certification
- May 23, 2020
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation · Non-profit
- Incorporated
- Oct 20, 1978 in MI
- Enrollment address
- 989 Spaulding Ave SE
Ada, MI 49301-3701
All disclosed owners & managing parties 23
| Name | Role | Since | Share |
|---|---|---|---|
| Michael L Damstra |
Corporate Director |
Jan 1, 2018 | |
| Sanford J Linden |
Corporate Director |
Jan 1, 2005 | |
| Bradley Killaly |
Corporate Officer |
Feb 22, 2023 | |
| Marcie M Hillary |
Corporate Officer |
Jan 26, 2011 | |
| W-2 Managing Employee |
Jan 26, 2011 | ||
| Patrick Miller |
Corporate Officer |
Mar 6, 2014 | |
| Corporate Director |
Jan 1, 2024 | ||
| Kristin L Whyte |
W-2 Managing Employee |
Aug 1, 2025 | |
| Brian M Connolly |
Corporate Director |
Feb 15, 2012 | |
| Eric Kaplan |
Corporate Officer |
May 1, 2025 | |
| Lee Ann Myers |
Corporate Officer |
Jan 1, 2012 | |
| W-2 Managing Employee | Jan 1, 2012 | ||
| Stuart Vander Heide |
W-2 Managing Employee |
Jun 26, 2023 | |
| Molly Petersen |
Corporate Director |
Aug 1, 2025 | |
| Krista Newman |
Corporate Officer |
Jan 1, 2024 | |
| Mary Sanders |
Corporate Director |
Oct 4, 2000 | |
| Hospice of Michigan, Inc. |
Operational/Managerial Control | Jan 1, 1987 | 100% |
| Kurt Ludlow |
Corporate Director |
Nov 12, 2009 | |
| Steven C Wade |
Corporate Director |
Jan 1, 2024 | |
| John Evangelisita |
Corporate Officer |
Jan 1, 2014 | |
| Gerald Fitzgerald |
Corporate Director |
Dec 1, 2007 | |
| John Raymond Maurer |
Corporate Director |
Jul 1, 2003 | |
| Jane McNamara |
Corporate Director |
Jan 1, 2005 | |
| Nancy Lynn Philappart |
Corporate Director |
Jan 1, 2024 | |
| Jamie L Cockerel |
Corporate Officer |
May 1, 2025 | |
| Michael a Jones |
Corporate Director |
Aug 1, 2025 |
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Hospice of Southeastern Michigan, Inc |
Hospice | Operational/Managerial Control (100%) | Sep 30, 1994 |
| Centrica Care Navigators |
Hospice | Operational/Managerial Control | Feb 1, 2024 |
| Hospice of Mecosta County |
Hospice | Operational/Managerial Control (100%) | Sep 30, 1994 |
| Arbor Hospice and Home Care |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 2016 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050620001022 | MI | Part a Provider - Hospice | 5496723660 | Practice locations: Ada, MI; Muskegon, MI |
National Provider Directory
- Tax ID family
- Hospice of Michigan Inc
Locations
1675 E Mount Garfield Rd
Ste 175
Muskegon, MI 49444
Phone (231) 773-5394
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
989 Spaulding Ave SE
Ada, MI 49301-3701
Mailing address
2366 Oak Valley Dr
Ann Arbor, MI 48103-8944
Phone (616) 454-1426
Other practice location 1
1675 E Mt Garfield Rd Ste 175
Muskegon, MI 49444-7732
Phone (231) 773-5394
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 151796120 | Medicaid | MI | |
| 08759 | Other | MI | BLUE CROSS BLUE SHIELD |
Other names
- Hospice of Western Michigan
Other providers in Ada, MI
- Julia Hilbert
- Jill Margaret Holkeboer
- Adam Edwin Homolka
- Ruth Hoogmoed
- Alexandria Horner
- Taylor Mary Howell
- Mary J. Hutchinson
- Jacob Kwast Chiropractic PLLC
- Jamal Fisher Therapy PLLC
- James D. Birmingham Rheumatology PLLC
All providers in Ada, MI · Community Based Hospice Care Agency in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.