Sun Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SUN HOSPICE INC

Practice address

1129 Iron Springs Road #104
Prescott,, AZ 86305

Phone

(928) 482-2462

NPI assigned

May 27, 2021

Last updated

May 27, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andy Kechejian

Title

Ceo

Phone

(928) 482-2462

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1548836828. Details of each certification follow.

• CCN 031757 Hospice · Active · Details

Hospice certification: CCN 031757

Legal name

SUN HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 30, 2021

Last certification

Nov 30, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

May 11, 2021 in AZ

Enrollment address

21501 N. 78TH Ave
Suite 100, Office 109
Peoria, AZ 85382-3355

Listed as

Sun Hospice IncCCN 031757 · All quality measures

Ownership

For-Profit

Certified

Nov 30, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 6

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

Owners & managing parties with NPI records 1

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

• Kirby Farnsworth, D.O.

  • Emergency Medicine Physician
  • Wickenburg, AZ
  • NPI 1124464839

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Kirby Farnsworth, D.O.

  • Emergency Medicine Physician
  • Wickenburg, AZ
  • NPI 1124464839

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1548836828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 IRON SPRINGS ROAD #104",
            "city": "PRESCOTT,",
            "state": "AZ",
            "postal_code": "86305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 IRON SPRINGS ROAD #104",
            "city": "PRESCOTT,",
            "state": "AZ",
            "postal_code": "86305",
            "telephone_number": "928-482-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "KECHEJIAN",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-482-2462"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.