NPIMap

Organization Active NPI

Optum Palliative and Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • Tucson, AZ
National Provider Identifier
1689735409
Registry record updated Nov 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
HSPC3896 Issued in AZ
Legal business name
OPTUM PALLIATIVE AND HOSPICE CARE, INC.
Practice address
6245 E. Broadway,
6TH Floor, Suite 650
Tucson, AZ 85711-4019
Phone
(520) 407-8000
Fax
(520) 748-5120
NPI assigned
Dec 13, 2006
Organization subpart
Yes
Parent organization
COLLABORATIVE CARE HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2015

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

Authorized official

Name
John O. Enderle
Title
President/Ceo
Phone
(860) 221-0793

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X
Community Based Hospice Care Agency 251G00000X HSPC3896 AZ Primary

Addresses

Primary practice location

6245 E. Broadway,
6TH Floor, Suite 650
Tucson, AZ 85711-4019

Mailing address

PO Box 15645
Las Vegas, NV 89114-5645
Phone (215) 902-8241

Other identifiers 1

IdentifierTypeStateIssuer
HSPC-3896OtherAZDOH LICENSE # - HOSPICE

Other names 1

  • Evercare Hospice, Inc. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1689735409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15645",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891145645",
            "telephone_number": "215-902-8241",
            "fax_number": "215-902-8809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 E. BROADWAY,",
            "address_2": "6TH FLOOR, SUITE 650",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857114019",
            "telephone_number": "520-407-8000",
            "fax_number": "520-748-5120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM PALLIATIVE AND HOSPICE CARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLLABORATIVE CARE HOLDINGS, LLC",
        "enumeration_date": "2006-12-13",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "ENDERLE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "860-221-0793"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "AZ",
            "license": "HSPC3896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOH LICENSE # - HOSPICE",
            "identifier": "HSPC-3896",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evercare Hospice, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; 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.