NPIMap

Organization Active NPI

Heartland Hospice Services LLC

  • Community Based Hospice Care Agency
  • Simpsonville, SC
National Provider Identifier
1619906757
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HPC-096 Issued in SC
Legal business name
HEARTLAND HOSPICE SERVICES LLC
Practice address
421 SE Main St
Suite 100
Simpsonville, SC 29681-2697
Phone
(864) 963-0045
Fax
(864) 963-0899
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Mr. Martin D Allen
Title
Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X HPC-096 SC Primary

Addresses

Primary practice location

421 SE Main St
Suite 100
Simpsonville, SC 29681-2697

Mailing address

333 N Summit St
Attn: Dean Shipman
Toledo, OH 43604-2635
Phone (419) 254-7841

Other identifiers 1

IdentifierTypeStateIssuer
HSP067MedicaidSC

Other names 1

  • ProMedica Hospice (Greenville) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200619000235 SC Part B Supplier - Clinic/Group Practice 4789592536 Receives reassigned benefits from 7 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Charleston, SC; Myrtle Beach, SC; Simpsonville, SC

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Change-of-ownership history 1

DateEventCounterparty
Nov 1, 2023 Change of OwnershipThis provider was the seller Heartland Hospice (Greenville)CCN 421558, SC, NPI 1588363899

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

Practitioners & affiliated clinicians

Practitioners 2

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": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1619906757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "ATTN: DEAN SHIPMAN",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042635",
            "telephone_number": "419-254-7841",
            "fax_number": "419-252-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SE MAIN ST",
            "address_2": "SUITE 100",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812697",
            "telephone_number": "864-963-0045",
            "fax_number": "864-963-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "SC",
            "license": "HPC-096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HSP067",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Greenville)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Greenville)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simpsonville, SC

Sources for this page

Verify at the official NPI Registry.