NPIMap

Organization Active NPI

Heartland Hospice Services, LLC

Doing business as ProMedica Hospice (Moline)

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Rock Island, IL
National Provider Identifier
1649913450
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Doing business as
ProMedica Hospice (Moline)
Practice address
2525 24TH St Ste 104
Rock Island, IL 61201-5395
Phone
(309) 757-7152
NPI assigned
Apr 19, 2022
Last updated
Apr 19, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HEARTLAND HOSPICE SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Authorized official

Name
Martin David Allen
Title
Sole Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X NU Primary

Addresses

Primary practice location

2525 24TH St Ste 104
Rock Island, IL 61201-5395

Mailing address

PO Box 10086
Toledo, OH 43699-0086
Phone (567) 585-1191

Other names 1

  • ProMedica Hospice (Moline) Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Promedica Hospice Shawnee33 organizations share this tax ID, including this one
Part of
Promedica Hospice Shawnee

Other organizations with this tax ID 32

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

View all 32

Locations

2525 24th St
Ste 104
Rock Island, IL 61201
Phone (309) 757-7152

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1649913450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 24TH ST STE 104",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015395",
            "telephone_number": "309-757-7152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Moline)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Island, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.