Heartland Hospice Services LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

HEARTLAND HOSPICE SERVICES LLC

Doing business as

ProMedica Hospice (Rockford)

Practice address

6000 E State St Ste 1
Rockford, IL 61108-2521

Phone

(815) 397-3691

NPI assigned

May 5, 2022

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Rockford) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

All disclosed owners & managing parties 14

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

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675987200000",
    "number": "1700521531",
    "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": "6000 E STATE ST STE 1",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082521",
            "telephone_number": "815-397-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-05",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100002511",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Rockford)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Rockford)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Healing Path of Rockford, PLLC
• Susan Lynn Heape, CNA
• Hearing Helpers Inc
• Hearing Pros Inc (Amplified Hearing Aid Centers)
• Heartland Hospice Services LLC (ProMedica Hospice (Rockford))
• Heartland Medical Supplies
• Margaret Elizabeth Heartlein
• Majid Heidarpour
• Judith Ann Heinschel, PHD APRN
• Heit Health and Wellness Center Inc

• Hospice and Palliative Medicine (Internal Medicine) Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.