Mountain Ridge Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

MOUNTAIN RIDGE HOSPICE, LLC

Practice address

3204 N Academy Blvd Ste 110
Colorado Springs, CO 80917-5162

Phone

(505) 238-0288

NPI assigned

Nov 12, 2021

Organization subpart

No

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

Authorized official

Name

Michelle Christensen, RN

Title

Owner Authorized Official

Phone

(719) 418-3475

Specialties & licenses 1

Addresses

Other names 1

• Mountain Ridge Hospice Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Hospice certification: CCN 061621

Legal name

MOUNTAIN RIDGE HOSPICE, LLC

Doing business as

MOUNTAIN RIDGE HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Sep 13, 2022

Last certification

Aug 25, 2022

Ownership / control type

Proprietary - Other

Organization structure

LLCProprietary

Incorporated

Nov 6, 2021 in CO

Enrollment address

3204 N Academy Blvd
Ste 110
Colorado Springs, CO 80917-5162

Listed as

Mountain Ridge Hospice, LLCCCN 061621

Certified

Sep 13, 2022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

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

Owners & managing parties with NPI records 1

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

• Eric James Strodtman, M.D.

  • Pediatrics Physician
  • Denver, CO
  • NPI 1316264682

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1760148829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3204 N ACADEMY BLVD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175162",
            "telephone_number": "719-418-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 N ACADEMY BLVD STE 110",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175162",
            "telephone_number": "505-238-0288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN RIDGE HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-12",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "719-418-3475",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "PMD",
            "affiliation": "N",
            "endpointDescription": "encrypted software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "encrypted ap",
            "address_1": "3204 N Academy Blvd Ste 110",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809175162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mountain Ridge Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountain Ridge Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.

Verify at the official NPI Registry.