Frontier Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

17E478 Issued in CO

Legal business name

FRONTIER HOSPICE, LLC

Practice address

4718 N Elizabeth St
Suite a
Pueblo, CO 81008-2079

Phone

(719) 544-5891

Fax

(719) 544-5895

NPI assigned

Oct 20, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Larry D Russell

Title

Administrator

Phone

(719) 544-5891

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Centercare Hospice LLC

  • Community Based Hospice Care Agency
  • Pueblo, CO
  • NPI 1245866474

  Sold to, 2020-06-01

  CMS change of ownership

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1770572737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4718 N ELIZABETH ST",
            "address_2": "SUITE A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082079",
            "telephone_number": "719-544-5891",
            "fax_number": "719-544-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4718 N ELIZABETH ST",
            "address_2": "SUITE A",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810082079",
            "telephone_number": "719-544-5891",
            "fax_number": "719-544-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "719-544-5891",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CO",
            "license": "17E478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16889355",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Front Range Urgent Care, Inc
• Front Range Urgent Care, Inc.
• Frontier Home Health, LLC
• Frontier Home Health, LLC
• Frontier Home Health, LLC
• Jenna Frost
• Paul Frutos, DO
• Tamra Frye
• Hunter Lee Fuentes, MD
• Samantha M Fuentes

• Community Based Hospice Care Agency in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Community Based Hospice Care Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.