NPIMap

Organization Active NPI

Fairhope Hospice & Palliative Care Inc

  • In Home Supportive Care Agency
  • Lancaster, OH
National Provider Identifier
1619420668
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
FAIRHOPE HOSPICE & PALLIATIVE CARE INC
Practice address
282 Sells Rd
Lancaster, OH 43130-3461
Phone
(740) 654-7077
Fax
(740) 475-0376
NPI assigned
Jul 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

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

Authorized official

Name
Kristin Glasure, LSW
Title
Ceo
Phone
(740) 654-7077

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
Case Management Agency 251B00000X
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

282 Sells Rd
Lancaster, OH 43130-3461

Mailing address

282 Sells Rd
Lancaster, OH 43130-3461
Phone (740) 654-7077

Other practice location 1

1319 E Main St
Lancaster, OH 43130-4005
Phone (740) 687-2229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170531000477 OH Part B Supplier - Clinic/Group Practice 0547319253 Receives reassigned benefits from 9 practitioners
Practice locations: Lancaster, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2312854Fairhope Palliative Care1319 E Main Street, Lancaster, OH 43130Certificate of waiverOct 20, 2026

National Provider Directory

National Provider Directory
Tax ID family
Fairhope Hospice Palliative Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1319 E Main St
Lancaster, OH 43130
Phone (740) 653-9411

401 N Ewing St
Lancaster, OH 43130
Phone (740) 687-8000

282 Sells Rd
Lancaster, OH 43130
Phone (740) 654-7077

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fairhope Hospice & Palliative Care, Inc.Lancaster, OH, CCN 361504 Hospice 5% Or Greater Direct Ownership Interest (100%) Jan 12, 1984

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1619420668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 SELLS RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303461",
            "telephone_number": "740-654-7077",
            "fax_number": "740-475-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 SELLS RD",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303461",
            "telephone_number": "740-654-7077",
            "fax_number": "740-475-0376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 E Main St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "OH",
            "postal_code": "431304005",
            "country_code": "US",
            "telephone_number": "740-687-2229",
            "fax_number": "740-687-2220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAIRHOPE HOSPICE & PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "GLASURE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "740-654-7077",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

Verify at the official NPI Registry.