NPIMap

Organization Active NPI

Sharon S. Richardson Hospice Home, Inc

Doing business as Sharon S. Richardson Community Hospice, Inc.

  • Community Based Hospice Care Agency
  • Sheboygan Falls, WI
National Provider Identifier
1598855207
Registry record updated Aug 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SHARON S. RICHARDSON HOSPICE HOME, INC
Doing business as
Sharon S. Richardson Community Hospice, Inc.
Sharon S. Richardson Hospice Home & Palliative Care Retreat
Practice address
W2862 State Road 28
Sheboygan Falls, WI 53085
Phone
(920) 467-1800
Fax
(920) 467-1900
NPI assigned
Oct 13, 2006
Last updated
Aug 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2024

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

Authorized official

Name
Marilyn L Masi
Title
Cfo
Phone
(920) 467-7969

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH1000X 114429-030 WI
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
Community Based Hospice Care Agency 251G00000X Primary
Inpatient Hospice 315D00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

W2862 State Road 28
Sheboygan Falls, WI 53085

Mailing address

W2850 State Road 28
Sheboygan Falls, WI 53085-2702
Phone (920) 467-1800

Other identifiers 1

IdentifierTypeStateIssuer
43191300MedicaidWI

Other names 2

  • Sharon S. Richardson Community Hospice, Inc. Doing business as
  • Sharon S. Richardson Hospice Home & Palliative Care Retreat Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061120000368 WI Part A Provider - Hospice 8729086152 Practice locations: Manitowoc, WI; Sheboygan Falls, WI
O20070213000012 WI Part B Supplier - Clinic/Group Practice 8729086152 Receives reassigned benefits from 4 practitioners
Practice locations: Sheboygan Falls, WI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598855207. Details of each certification follow.

Hospice certification: CCN 521582

Legal name
SHARON S RICHARDSON HOSPICE HOME INC
Doing business as
SHARON S. RICHARDSON COMMUNITY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 11, 2007
Last certification
Aug 11, 2021
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Jul 20, 2004 in WI
Enrollment address
W2850 State Road 28
Sheboygan Falls, WI 53085-2702

Care Compare: Hospice

Medicare Care Compare
Listed as
Sharon S Richardson Community HospiceCCN 521582 · All quality measures
Ownership
For-Profit
Certified
May 11, 2007
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

4411 Calumet Ave
Ste 4
Manitowoc, WI 54220
Phone (920) 374-4180

1118 Plankview Green Blvd
Sheboygan Falls, WI 53085
Phone (920) 467-1800

W2850 State Road 28
Sheboygan Falls, WI 53085
Phone (920) 467-1800

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Eric Tetzlaff Individual Corporate Officer Nov 1, 2017
Corporate DirectorExecutive Director Nov 1, 2017
W-2 Managing EmployeeAd; Nov 1, 2017 100%
Ashley Elizabeth Albers Individual Contracted Managing EmployeeAssociate Medical Director May 18, 2026
Marilyn L Masi Individual Corporate Officer Dec 1, 2017
Corporate DirectorController Dec 1, 2017
W-2 Managing EmployeeController Dec 1, 2017 15%
Steve Meyer Individual Corporate Officer Apr 15, 2009
Corporate DirectorBoard Member Apr 15, 2009
Operational/Managerial ControlBoard President Jun 14, 2023
Joe Voelkner Individual Corporate DirectorBoard Member Apr 15, 2010
Joseph III Richardson Individual Corporate DirectorBoard Member Apr 15, 2007
Bryan Wayne Howington Individual Contracted Managing EmployeeMD; May 18, 2026
Charmaine M Conrad Individual Corporate OfficerChief Operating Officer Jun 14, 2016
Corporate DirectorChief Operating Officer Jun 14, 2016
W-2 Managing EmployeeChief Operating Officer Jun 14, 2016
James B Kuplic Individual Corporate DirectorBoard Member Apr 15, 2013
Barbara Gannon Individual Corporate DirectorBoard Member Apr 15, 2012

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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.

Affiliated clinicians 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1598855207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W2850 STATE ROAD 28",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530852702",
            "telephone_number": "920-467-1800",
            "fax_number": "920-467-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W2862 STATE ROAD 28",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "53085",
            "telephone_number": "920-467-1800",
            "fax_number": "920-467-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARON S. RICHARDSON HOSPICE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "MASI",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "920-467-7969"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Hospice",
            "state": "WI",
            "license": "114429-030",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43191300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharon S. Richardson Community Hospice, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharon S. Richardson Hospice Home & Palliative Care Retreat",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sharon S. Richardson Hospice Home & Palliative Care Retreat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sheboygan Falls, WI

Sources for this page

Verify at the official NPI Registry.