NPIMap

Organization Active NPI

Elk City Comforting Hands Hospice LLC

  • Community Based Hospice Care Agency
  • Elk City, OK
National Provider Identifier
1669782264
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ELK CITY COMFORTING HANDS HOSPICE LLC
Practice address
401 E 3Rd St
Suite B
Elk City, OK 73644-4719
Phone
(580) 225-1738
Fax
(580) 225-1843
NPI assigned
Oct 15, 2010
Last updated
May 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Authorized official

Name
Mr. Sam J Hill
Title
Secretary
Phone
(580) 225-1738

Specialties & licenses 1

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

Addresses

Primary practice location

401 E 3Rd St
Suite B
Elk City, OK 73644-4719

Mailing address

401 E 3Rd St
Suite B
Elk City, OK 73644-4719
Phone (580) 225-1738

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110531000421 OK Part A Provider - Hospice 1254518277 Practice locations: Elk City, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669782264. Details of each certification follow.

Hospice certification: CCN 371698

Legal name
ELK CITY COMFORTING HANDS HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jan 24, 2012
Last certification
Nov 20, 2014
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Aug 12, 2010 in OK
Enrollment address
401 E 3Rd Street
Suite B
Elk City, OK 73644-4719

Care Compare: Hospice

Medicare Care Compare
Listed as
Elk City Comforting Hands Hospice LLCCCN 371698 · All quality measures
Ownership
Other
Certified
Jan 24, 2012
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
37D2029303Elk City Comforting Hands Hospice, LLC401 E 3Rd St, Elk City, OK 73644Certificate of waiverSep 5, 2027

National Provider Directory

National Provider Directory

Locations

401 E 3rd St
Ste B
Elk City, OK 73644
Phone (580) 225-1738

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Tony Wilkins Individual 5% Or Greater Direct Ownership Interest Jan 1, 2011 33.3%
Corporate Director Jan 1, 2011
Alexander Dout Individual 5% Or Greater Direct Ownership InterestMember Jan 1, 2011 33.4%
Corporate Director Jan 1, 2011
David Bank Individual Contracted Managing Employee Jan 1, 2011
Samuel Hill Individual 5% Or Greater Direct Ownership InterestMember Jan 1, 2011 33.3%
Corporate Director Jan 1, 2011
Carrie Perry Individual W-2 Managing Employee Jan 1, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 8

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": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1669782264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E 3RD ST",
            "address_2": "SUITE B",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444719",
            "telephone_number": "580-225-1738",
            "fax_number": "580-225-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E 3RD ST",
            "address_2": "SUITE B",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736444719",
            "telephone_number": "580-225-1738",
            "fax_number": "580-225-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK CITY COMFORTING HANDS HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "580-225-1738",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.