Hospice Advantage, LLC,
Organization Active NPI Community Based Hospice Care Agency · Green Bay, WI
NPI 1801136643 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1801136643
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- License
- 2036 (WI)
- Legal business name
- HOSPICE ADVANTAGE, LLC,
- Practice address
- 2960 Allied St Ste 105
Green Bay, WI 54304-5542 - Phone
- (920) 321-2004
- Fax
- (920) 321-2005
- NPI assigned
- Feb 14, 2013
- Organization subpart
- No
Authorized official
- Name
- Russell Adkins
- Title
- SVP General Counsel
- Phone
- (615) 309-5668
Owners & managing parties with NPI records 2
-
Kelsey Kienert, M.D.
Corporate family (same tax ID) 36
Member of 1
Facilities with the same owner 162
Affiliated clinicians 16
-
Courtney Forte, MD
-
Shayna Kamin, DO
-
Kelsey Kienert, M.D.
-
Tomasz Michalski, MD
-
Scott Robert Schinschke, D.O.
-
Todd J Talbot, DO
Medicare Care Compare: Hospice
- Listed as
- Compassus Green Bay
- Ownership
- For-Profit
- Certified
- Jul 19, 2013
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Hospice certification: CCN 521595
- Legal name
- HOSPICE ADVANTAGE LLC
- Doing business as
- COMPASSUS-GREEN BAY
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Jul 19, 2013
- Last certification
- Jul 19, 2013
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Sep 8, 2004 in FL
- Enrollment address
- 2960 Allied St
Ste 105
Green Bay, WI 54304-5542
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Compassus Parent, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 100% |
| FC Compassus LLC |
5% Or Greater Indirect Ownership Interest | Oct 7, 2015 | 87% |
| Russell G Adkins |
Corporate Officer |
Oct 7, 2015 | |
| Operational/Managerial Control |
Oct 7, 2015 | ||
| Compassus Holdings, L.P. |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 100% |
| Ascension Towerbrook Healthcare Opportunities LP |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 49.5% |
| Ascension Capital, LLC |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 49.48% |
| Laura a Templeton |
Corporate Officer |
Apr 12, 2023 | |
| Operational/Managerial Control |
Apr 12, 2023 | ||
| Ascension Health Alliance |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 49.48% |
| Community Hospices of America, LLC. |
Operational/Managerial Control | Jun 1, 2017 | 100% |
| Ti V Compassus Investment Aggregator, L.P. |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 49.5% |
| Hospice Advantage Midco LLC |
5% Or Greater Direct Ownership Interest | Oct 7, 2015 | 100% |
| Towerbrook Investors V (Onshore) LP |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 29.75% |
| Hospice Advantage Holdings, LLC |
5% Or Greater Indirect Ownership Interest | Oct 7, 2015 | 100% |
| Towerbrook Investors V (892), L.P. |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 14.14% |
| FC Compassus Hospice Blocker, LLC |
5% Or Greater Indirect Ownership Interest | Oct 7, 2015 | 13% |
| Stacey Werner |
W-2 Managing Employee |
Sep 23, 2024 | |
| Compassus Intermediate, Inc. |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 100% |
| Michael Asselta |
Corporate Officer |
May 2, 2024 | |
| Ti V ASC Compassus Investment Aggregator LP |
5% Or Greater Indirect Ownership Interest | Dec 31, 2019 | 99% |
| Kelsey M Kienert |
Contracted Managing Employee |
Apr 5, 2021 |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Compassus-Florence |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Dec 14, 2012 |
| Compassus- North Georgia II |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Oct 7, 2015 |
| Compassus - Auburn |
Hospice | 5% Or Greater Direct Ownership Interest (100%) | Dec 14, 2012 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130311000169 | WI | Part a Provider - Hospice | 3779544960 | Practice locations: Green Bay, WI |
National Provider Directory
- Tax ID family
- Hospice Advantage LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 2036 | WI | Yes |
Addresses
Primary practice location
2960 Allied St Ste 105
Green Bay, WI 54304-5542
Mailing address
10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022
Other providers in Green Bay, WI
- Jean Horak
- Richard David Horak
- Richard J Horak
- Katherine April Horkman
- Kennan F Horn
- Hospice Advantage, LLC.
- Hospital Diagnostic Services
- John Martin Hosten
- Gope C Hotchandani
- Emily Joy Hotchkiss
All providers in Green Bay, WI · Community Based Hospice Care Agency in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.