Active NPI
Holistic Hospice Inc
- Community Based Hospice Care Agency
- Greenfield, WI
National Provider Identifier
1720523210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- HOLISTIC HOSPICE INC
- Practice address
- 8777 W Forest Home Ave
Greenfield, WI 53228-3421 - Phone
- (414) 231-3130
- Fax
- (414) 239-8544
- NPI assigned
- Dec 20, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Sahr Lebbie
- Title
- President
- Phone
- (414) 231-3130
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
8777 W Forest Home Ave
Greenfield, WI 53228-3421
Mailing address
3422 W Howard Ave
Greenfield, WI 53221-1208
Phone (414) 231-3130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170403002410 | WI | Part A Provider - Hospice | 6608152707 | Practice locations: Greenfield, WI |
Hospice certification: CCN 521601
- Legal name
- HOLISTIC HOSPICE INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 17, 2017
- Last certification
- Nov 17, 2017
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Incorporated
- Nov 28, 2016 in WI
- Enrollment address
- 8777 W Forest Home Ave
Greenfield, WI 53228-3421
Care Compare: Hospice
Medicare Care Compare- Listed as
- Holistic Hospice
- Ownership
- For-Profit
- Certified
- Nov 17, 2017
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2128360 | Holistic Hospice | Certificate of waiver | Mar 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
3422 W Howard Ave
Greenfield, WI 53221
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Malik S Ali | Operational/Managerial Control | Jan 1, 2018 | |
| Sahr Lebbie | 5% Or Greater Direct Ownership Interest | Oct 1, 2018 | 97.5% |
| Corporate Officer | Nov 28, 2016 | 50% | |
| W-2 Managing Employee | Nov 28, 2016 | 100% | |
| Turgut Z Zia | Operational/Managerial Control | Jan 1, 2017 | |
| Josie Rupnick | Corporate Officer | Nov 26, 2016 | 25% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1124037437
Operational/Managerial Control
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699783894
Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 13
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": "1482192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731456000000",
"number": "1720523210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3422 W HOWARD AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532211208",
"telephone_number": "414-231-3130",
"fax_number": "414-239-8544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8777 W FOREST HOME AVE",
"city": "GREENFIELD",
"state": "WI",
"postal_code": "532283421",
"telephone_number": "414-231-3130",
"fax_number": "414-239-8544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOLISTIC HOSPICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2016-12-20",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A",
"authorized_official_last_name": "LEBBIE",
"authorized_official_first_name": "SAHR",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "414-231-3130"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.