Active NPI
Hospice of the Treasure Coast Inc
- Community Based Hospice Care Agency
- Fort Pierce, FL
National Provider Identifier
1598876088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 5033096
- Legal business name
- HOSPICE OF THE TREASURE COAST INC
- Practice address
- 5000-5090 Dunn Road
Fort Pierce, FL 34981 - Phone
- (772) 462-8999
- Fax
- (772) 781-8723
- NPI assigned
- Aug 31, 2006
- Organization subpart
- Yes
- Parent organization
- HEALTH AND PALLATIVE SERVICES OF THE TREASURE COAST INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Jackie Kendrick
- Title
- Ceo
- Phone
- (772) 403-4500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 5033096 | FL | Primary |
Addresses
Primary practice location
5000-5090 Dunn Road
Fort Pierce, FL 34981
Mailing address
1201 SE Indian Street
Stuart, FL 34997
Phone (772) 403-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 087528700 | Medicaid | FL |
Other names 1
- Treasure Coast Hospice St. Lucie
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050513000028 | FL | Part A Provider - Hospice | 8729029400 | Practice locations: Fort Pierce, FL |
Hospice certification: CCN 101517
- Legal name
- HOSPICE OF THE TREASURE COAST INC
- Doing business as
- TREASURE COAST HOSPICE OF ST LUCIE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 27, 1984
- Last certification
- Mar 22, 2022
- Ownership / control type
- Other
- Organization structure
- Corporation
- Incorporated
- Sep 2, 1981 in FL
- Enrollment address
- 5090 Dunn Rd
Fort Pierce, FL 34981-4941
Care Compare: Hospice
Medicare Care Compare- Listed as
- Treasure Coast Hospice of St Lucie
- Ownership
- Other
- Certified
- Nov 27, 1984
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
5090 NW Dunn Rd
Fort Pierce, FL 34981
Phone (772) 403-4552
Ownership & related parties
All disclosed owners & managing parties 23
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Richard Leigh Lynch | Corporate Director | Jul 30, 2013 | |
| Cynthia Lennard | Corporate Director | Oct 1, 2024 | |
| Jackie Kendrick | Corporate Officer | Jul 1, 2019 | |
| Peter W Culley | Corporate Director | Apr 11, 2022 | |
| William Duwane Pickens | Corporate Director | Oct 1, 2024 | |
| Richard Paul Mishock | Corporate Director | Oct 24, 2019 | |
| Carl Martello | W-2 Managing Employee | Jul 26, 2011 | |
| Ewald Wesley Bender | Corporate Director | Oct 23, 2018 | |
| Health and Palliative Services of the Treasure Coast | 5% Or Greater Direct Ownership Interest | Oct 1, 2004 | |
| Mary Ann Alderman | Corporate Director | Oct 1, 2024 | |
| Glenn Allen Beville | Contracted Managing Employee | Jul 1, 2019 | |
| Operational/Managerial Control | Jul 1, 2019 | ||
| Mike Ammen | Corporate Director | Oct 1, 2024 | |
| Patrick Lawrence Silas | Corporate Director | Apr 11, 2022 | |
| Mary Coleman | Corporate Director | Oct 1, 2024 | |
| Jimmy Anne Haisley | Corporate Director | Oct 24, 2017 | |
| Philip Y Berger | Corporate Director | Jul 27, 2021 | |
| Christopher McAlpine | Corporate Director | Oct 1, 2024 | |
| Scott Hoffman | Corporate Director | Oct 24, 2017 | |
| Ann Louise Decker | Corporate Director | Jan 25, 2022 | |
| Tony Hurt | Corporate Director | Oct 1, 2024 | |
| Eileen Moore Emery | Corporate Director | Oct 24, 2023 | |
| John C Crouch | W-2 Managing Employee | Feb 24, 2024 | |
| William George Clifford | Corporate Director | Jan 28, 2020 |
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 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Stuart, FL
- NPI 1699886184
Health and Palliative Services of the Treasure Coast
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Fort Pierce, FL
- NPI 1912077108
Family Medicine
Affiliated clinicians 18
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Miami, FL
- NPI 1962873323
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1566172800000",
"number": "1598876088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 SE INDIAN STREET",
"city": "STUART",
"state": "FL",
"postal_code": "34997",
"telephone_number": "772-403-4500",
"fax_number": "772-781-8423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5000-5090 DUNN ROAD",
"city": "FORT PIERCE",
"state": "FL",
"postal_code": "34981",
"telephone_number": "772-462-8999",
"fax_number": "772-781-8723"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOSPICE OF THE TREASURE COAST INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEALTH AND PALLATIVE SERVICES OF THE TREASURE COAST INC",
"enumeration_date": "2006-08-31",
"last_updated": "2019-08-19",
"status": "A",
"authorized_official_last_name": "KENDRICK",
"authorized_official_first_name": "JACKIE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "772-403-4500",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "FL",
"license": "5033096",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "087528700",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Treasure Coast Hospice St. Lucie",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Treasure Coast Hospice St. Lucie",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fort Pierce, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.