NPIMap

Organization Active NPI

Evergreen Hospice LLC

Doing business as Luminos Hospice

  • Community Based Hospice Care Agency
  • Tulsa, OK
National Provider Identifier
1740339548
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
4194 Issued in OK
Legal business name
EVERGREEN HOSPICE LLC
Doing business as
Luminos Hospice
Practice address
4110 S Rockford Ave Ste 201
Tulsa, OK 74105-4251
Phone
(918) 250-5555
NPI assigned
Jan 9, 2007
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Hayley J Hughes
Title
Chief Stratgegy Officer
Phone
(918) 250-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 4194 OK Primary

Addresses

Primary practice location

4110 S Rockford Ave Ste 201
Tulsa, OK 74105-4251

Mailing address

4110 S Rockford Ave Ste 201
Tulsa, OK 74105-4251
Phone (918) 250-5555

Other names 1

  • Luminos Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120425000311 OK Part A Provider - Hospice 9830178086 Practice locations: Tulsa, OK; Chandler, OK

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740339548. Details of each certification follow.

Hospice certification: CCN 371644

Legal name
EVERGREEN HOSPICE LLC
Doing business as
LUMINOS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 22, 2004
Last certification
Apr 1, 2021
Ownership / control type
Proprietary - Individual
Organization structure
LLCProprietary
Enrollment address
4110 S Rockford Ave
Ste 201
Tulsa, OK 74105-4251

Care Compare: Hospice

Medicare Care Compare
Listed as
Luminos HospiceCCN 371644 · All quality measures
Ownership
For-Profit
Certified
Sep 22, 2004
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

4110 S Rockford Ave
Ste 201
Tulsa, OK 74105
Phone (918) 250-5555

9902 E 43rd St
Ste A
Tulsa, OK 74146
Phone (918) 250-5555

9916 E 43rd St
Ste E
Tulsa, OK 74146
Phone (918) 250-5555

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Donald Huffman Individual 5% Or Greater Indirect Ownership Interest Dec 5, 2023 5.1%
Luminos Aggregator LLC Organization, New York, NY Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 71.49%
Kain Hospice LLC Organization, New York, NY LLC, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 12.7%
Aspire Partners LP Organization, New York, NY Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 7.2%
Todd Fitch Individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 10.6%
Luminos Intermediate LLC Organization, Austin, TX Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 99.99%
Kain Pera Feeder LP Organization, New York, NY Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 7%
Luminos Opco2 LLC Organization, Tulsa, OK Created for acquisition, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 5, 2023 100%
Christopher G Willis Individual 5% Or Greater Indirect Ownership InterestCeo Dec 5, 2023 27%
Corporate Officer Feb 27, 2026
Sharon Reed Individual 5% Or Greater Direct Ownership Interest Dec 5, 2023 5.1%
Eric G Flegel Individual Contracted Managing EmployeeMD; Mar 6, 2024
Adrianne L Hauser Individual W-2 Managing EmployeeAd; Jan 30, 2006 10%
Hayley Hughes Individual 5% Or Greater Indirect Ownership Interest Dec 5, 2023 7.4%
Kain Pera LP Organization, New York, NY Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 27, 2026 25.3%
Luminos Holdco LLC Organization, Austin, TX Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Dec 5, 2023 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 7

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1740339548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 S ROCKFORD AVE STE 201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741054251",
            "telephone_number": "918-250-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 S ROCKFORD AVE STE 201",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741054251",
            "telephone_number": "918-250-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF STRATGEGY OFFICER",
        "authorized_official_telephone_number": "918-250-5555"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luminos Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.