NPIMap

Organization Active NPI

Sycamore Grove Healthcare LLC

Doing business as Ardent Hospice of Fresno

  • Community Based Hospice Care Agency
  • Fresno, CA
National Provider Identifier
1639826613
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SYCAMORE GROVE HEALTHCARE LLC
Doing business as
Ardent Hospice of Fresno
Practice address
5477 N Fresno St Ste 104
Fresno, CA 93710-6079
Phone
(595) 408-5945
NPI assigned
Mar 9, 2022
Last updated
Oct 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

5477 N Fresno St Ste 104
Fresno, CA 93710-6079

Mailing address

5477 N Fresno St Ste 104
Fresno, CA 93710-6079
Phone (595) 408-5945

Other names 1

  • Ardent Hospice of Fresno Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220912001672 CA Part A Provider - Hospice 9537544531 Practice locations: Fresno, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639826613. Details of each certification follow.

Hospice certification: CCN 751750

Legal name
SYCAMORE GROVE HEALTHCARE LLC
Doing business as
ARDENT HOSPICE OF FRESNO
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 18, 2015
Last certification
Oct 5, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Mar 3, 2022 in NV
Enrollment address
2040 N Winery Ave
Ste 102
Fresno, CA 93703-4814

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
Ardent Hospice of FresnoCCN 751750 · All quality measures
Ownership
For-Profit
Certified
Dec 18, 2015
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2078256Sycamore Grove Healthcare LLC5477 N Fresno St Ste 104, Fresno, CA 93710Certificate of waiverMay 22, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ardent Home Health of Fresno3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2040 N Winery Ave
Ste 102
Fresno, CA 93703
Phone (559) 408-5945

5477 N Fresno St
Ste 104
Fresno, CA 93710
Phone (595) 408-5945

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
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Aug 16, 2022 100%
Kimberly D Shoop Individual W-2 Managing EmployeeAd; Mar 1, 2025
Michael Magette Individual Corporate OfficerTreasurer Apr 10, 2024
Brent Guerisoli Individual Corporate DirectorDirector and Sole Board Member Aug 1, 2022
Dzung Trinh Individual W-2 Managing EmployeeMD; Mar 1, 2021
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Aug 16, 2022 100%
John J Gochnour Individual Corporate OfficerPresident / LLC Manager Apr 10, 2024
Amber Tueller Individual Corporate OfficerSecretary Apr 10, 2024
Elliot McMillan Individual Corporate OfficerVice President Apr 10, 2024

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
Aug 16, 2022 Change of OwnershipThis provider was the buyer Ardent Hospice & Palliative Care of Fresno, Inc.CCN 751750, CA, NPI 1831510999

Change of ownership 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1639826613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5477 N FRESNO ST STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106079",
            "telephone_number": "595-408-5945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5477 N FRESNO ST STE 104",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937106079",
            "telephone_number": "595-408-5945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYCAMORE GROVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ardent Hospice of Fresno",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.