Heartland Hospice Services, LLC

Primary specialty

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

Legal business name

HEARTLAND HOSPICE SERVICES, LLC

Practice address

1385 Chews Landing Rd Unit 4
Laurel Springs, NJ 08021-2760

Phone

(856) 251-0707

NPI assigned

Apr 19, 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 (Woodbury) Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Heartland Hospice Services LLC

  • Community Based Hospice Care Agency
  • Laurel Springs, NJ
  • NPI 1396798112

  O20200622002854

  Same enrollment
• Heartland Hospice Services LLC

  • Community Based Hospice Care Agency
  • Northfield, NJ
  • NPI 1811406598

  O20200622002854

  Same enrollment
• Heartland Hospice Services, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Northfield, NJ
  • NPI 1952044786

  O20200622002854

  Same enrollment

Locations

Practitioners 2

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

• Jenna Connor

  • Gerontology Nurse Practitioner
  • Laurel Springs, NJ
  • NPI 1639863772
  NPD
• Caitlin Fazio, NP

  • Gerontology Nurse Practitioner
  • Sewell, NJ
  • NPI 1578270757
  NPD

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1760125595",
    "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": "1385 CHEWS LANDING RD UNIT 4",
            "city": "LAUREL SPRINGS",
            "state": "NJ",
            "postal_code": "080212760",
            "telephone_number": "856-251-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "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": "8739200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Woodbury)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sean Hart
• Heartland Hospice Services LLC
• Heartland Hospice Services, LLC
• Andrea Hersh, RD
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• Hal M Hirsch, DMD, FAGD
• Hope Rising Health Care LLC
• Valerie M Iadanza-Brumbach, RPH

• Hospice and Palliative Medicine (Internal Medicine) Physician in Laurel Springs, NJ
• Providers in Laurel Springs, NJ by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.