NPIMap

Organization Active NPI

Exemplar Healthcare, Inc.

Doing business as Symbii Hospice South

  • Community Based Hospice Care Agency
  • Murray, UT
National Provider Identifier
1629591003
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
EXEMPLAR HEALTHCARE, INC.
Doing business as
Symbii Hospice South
Practice address
308 E 4500 S Ste 100
Murray, UT 84107-4057
Phone
(801) 433-0344
Fax
(801) 433-0075
NPI assigned
Jul 18, 2017
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Amber L Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

308 E 4500 S Ste 100
Murray, UT 84107-4057

Mailing address

308 E 4500 S Ste 100
Murray, UT 84107-4057
Phone (801) 433-0344

Other practice location 1

894 E 100 N
Price, UT 84501-2711
Phone (435) 637-7225

Other practice location 2

1924 N 1120 W
Provo, UT 84604-1045
Phone (801) 655-4272

Other names 1

  • Symbii Hospice South Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190124002056 UT Part A Provider - Hospice 2163769472 Practice locations: Murray, UT; Price, UT; Provo, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629591003. Details of each certification follow.

Hospice certification: CCN 461606

Legal name
EXEMPLAR HEALTHCARE, INC.
Doing business as
SYMBII HOSPICE SOUTH
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 9, 2014
Last certification
Sep 29, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 14, 2017 in NV
Enrollment address
308 E 4500 S
Ste 100
Murray, UT 84107-4057

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Symbii Hospice SouthCCN 461606 · All quality measures
Ownership
For-Profit
Certified
May 9, 2014
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Exemplar Healthcare 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

1924 N 1120 W
Provo, UT 84604
Phone (385) 235-8422

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kevin W Tschetter Individual Contracted Managing EmployeeMD; Dec 1, 2024
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 2018 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 25, 2026
Brent Guerisoli Individual Corporate DirectorDirector & Sole Board Member Jul 30, 2018
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
Tella Silver Individual W-2 Managing EmployeeAd; May 15, 2024
John J Gochnour Individual Corporate OfficerPresident Jun 6, 2024
Amber Tueller Individual Corporate OfficerSecretary Jun 6, 2024
Elliot McMillan Individual Corporate OfficerSecretary Dec 1, 2018

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 141

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 141

Change-of-ownership history 1

DateEventCounterparty
Dec 1, 2018 Change of OwnershipThis provider was the buyer Cornerstone HospiceCCN 461606, UT, NPI 1194155010

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1629591003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 E 4500 S STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074057",
            "telephone_number": "801-433-0344",
            "fax_number": "801-433-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 E 4500 S STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841074057",
            "telephone_number": "801-433-0344",
            "fax_number": "801-433-0075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "894 E 100 N",
            "address_purpose": "LOCATION",
            "city": "Price",
            "state": "UT",
            "postal_code": "845012711",
            "country_code": "US",
            "telephone_number": "435-637-7225",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1924 N 1120 W",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846041045",
            "country_code": "US",
            "telephone_number": "801-655-4272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXEMPLAR HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Symbii Hospice South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.