Heartland Hospice Services, LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

HEARTLAND HOSPICE SERVICES, LLC

Doing business as

ProMedica Hospice (Bad Axe)

Practice address

1171 S Van Dyke Rd Ste C&D
Bad Axe, MI 48413-9624

Phone

(989) 269-2522

NPI assigned

Jun 3, 2022

Organization subpart

Yes

Parent organization

HEARTLAND HOSPICE SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Martin David Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Bad Axe) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Part of

Heartland Hospice-Tulsa

All disclosed owners & managing parties 14

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

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654214400000",
    "number": "1609515964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041531",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1171 S VAN DYKE RD STE C&D",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484139624",
            "telephone_number": "989-269-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "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": "1451313",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Bad Axe)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tracey Harwood
• Diana Rose Hass, DDS
• Bethany Hasting
• Mary Kathleen Hazel, CCC-SLP
• Hearing Services of Bad Axe
• Tracie Jo Henline, NP
• Diana Hickey, NP
• Kendra Hill
• Hills & Dales General Hospital
• Hills & Dales General Hospital, Inc.

• Hospice and Palliative Medicine (Internal Medicine) Physician in Bad Axe, MI
• Providers in Bad Axe, MI by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.