Organization Active NPI

Heartland Home Care, LLC

  • Community Based Hospice Care Agency
  • Roanoke, VA
National Provider Identifier
1629470745
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HEARTLAND HOME CARE, LLC
Practice address
2840 Electric Rd Ste 106a
Roanoke, VA 24018-3551
Phone
(540) 725-7600
Fax
(877) 385-9446
NPI assigned
Sep 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Authorized official

Name
Martin D Allen
Title
Director
Phone
(419) 252-5500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2840 Electric Rd Ste 106a
Roanoke, VA 24018-3551

Mailing address

333 N Summit St
Licensure Support
Toledo, OH 43604-2615
Phone (419) 252-5500

Other identifiers 1

IdentifierTypeStateIssuer
1629470745MedicaidVA

Other names 1

  • ProMedica Hospice (Roanoke) Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191206000039 VA Part B Supplier - Clinic/Group Practice 4789592817 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Lynchburg, VA; Roanoke, VA

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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 (Roanoke)CCN 491617, VA, NPI 1720787047

Change of ownership 1

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1411084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1629470745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "address_2": "LICENSURE SUPPORT",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 ELECTRIC RD STE 106A",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183551",
            "telephone_number": "540-725-7600",
            "fax_number": "877-385-9446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOME CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "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": "419-252-5500"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal 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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629470745",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Roanoke)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.