Organization Active NPI

Lily Home and Hospice

  • Community Based Hospice Care Agency
  • Eau Claire, WI
National Provider Identifier
1700564937
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LILY HOME AND HOSPICE
Practice address
4423 Golf Ter Ste a
Eau Claire, WI 54701-4902
Phone
(262) 421-6004
Fax
(262) 537-5140
NPI assigned
Jul 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Authorized official

Name
Keith Rasimus
Title
Ceo
Phone
(715) 201-2233

Specialties & licenses 1

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

Addresses

Primary practice location

4423 Golf Ter Ste a
Eau Claire, WI 54701-4902

Mailing address

15430 W Capitol Dr Ste 100
Brookfield, WI 53005-2626
Phone (262) 235-3115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240124003638 WI Part A Provider - Hospice 2163875337 Practice locations: Eau Claire, WI

Hospice certification: CCN 521621

Legal name
LILY HOME AND HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 29, 2024
Last certification
Feb 8, 2024
Organization structure
LLCProprietary
Incorporated
Jun 25, 2023 in WI
Enrollment address
4423 Golf Ter
Ste a
Eau Claire, WI 54701-4902

Care Compare: Hospice

Medicare Care Compare
Listed as
Lily Home and HospiceCCN 521621
Certified
Feb 29, 2024
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
52D2323010Lily Home and Hospice LLC4423 Golf Terrace, Ste a, Eau Claire, WI 54701Certificate of waiverApr 29, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Sarah Schorsch Individual Contracted Managing EmployeeAdministrator Jul 10, 2023 30%
Tracy Merle Geiger Individual 5% Or Greater Indirect Ownership Interest Jun 25, 2023 100%
Corporate OfficerPresident Jun 25, 2023 80%
Operational/Managerial Control Jun 25, 2023 100%
Lily Hospice LLC Organization, Cedarburg, WI LLC 5% Or Greater Direct Ownership Interest Jun 25, 2023 100%
Operational/Managerial Control Jun 25, 2023 100%
Aron S Adkins Individual Contracted Managing EmployeeMedical Director Jul 10, 2023 20%

Owners & managing parties with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 6

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": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1700564937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15430 W CAPITOL DR STE 100",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530052626",
            "telephone_number": "262-235-3115",
            "fax_number": "262-537-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 GOLF TER STE A",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014902",
            "telephone_number": "262-421-6004",
            "fax_number": "262-537-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LILY HOME AND HOSPICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "RASIMUS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "715-201-2233"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

Verify at the official NPI Registry.