NPIMap

Organization Active NPI

Adventhealth Home Health and Hospice Inc

Doing business as Adventhealth Hospice

  • Community Based Hospice Care Agency
  • Ormond Beach, FL
National Provider Identifier
1801990429
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Doing business as
Adventhealth Hospice
Adventhealth Hospice Care East Florida
Florida Hospital Hospice Care
Practice address
770 W Granada Blvd Ste 304
Ormond Beach, FL 32174-5180
Phone
(386) 671-2138
Fax
(386) 672-0314
NPI assigned
Sep 12, 2006
Last updated
Jan 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Authorized official

Name
Mark Wheeler
Title
Cfo
Phone
(530) 545-1409

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary
Inpatient Hospice 315D00000X 5039096 FL

Addresses

Primary practice location

770 W Granada Blvd Ste 304
Ormond Beach, FL 32174-5180

Mailing address

770 W Granada Blvd Ste 304
Ormond Beach, FL 32174-5180
Phone (386) 671-2138

Other identifiers 3

IdentifierTypeStateIssuer
592951991010OtherFLTRICARE
U38OtherFLBLUE CROSS
150003100MedicaidFL

Other names 4

  • ADVENTHEALTH HOSPICE Doing business as
  • ADVENTHEALTH HOSPICE CARE EAST FLORIDA Doing business as
  • Florida Hospital Hospice Care Doing business as
  • MEMORIAL HOSPITAL FLAGLER INC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251112002503 FL Part A Provider - Hospice 9830133941 Practice locations: Ormond Beach, FL; Palm Coast, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801990429. Details of each certification follow.

Hospice certification: CCN 101539

Legal name
ADVENTHEALTH HOME HEALTH AND HOSPICE INC
Doing business as
ADVENTHEALTH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 6, 1996
Last certification
Sep 15, 2021
Ownership / control type
Non-Profit - Church
Organization structure
CorporationNon-profit
Enrollment address
770 W Granada Blvd
Ste 304
Ormond Beach, FL 32174-5180

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Adventhealth Hospice Care East FloridaCCN 101539 · All quality measures
Ownership
Non-Profit
Certified
Aug 6, 1996
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Adventhealth Home Health and Hospice Inc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

770 W Granada Blvd
Ste 304
Ormond Beach, FL 32174
Phone (386) 231-5298

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Lee Adler Individual Corporate DirectorDirector Jan 1, 2025
Farlen Halikman Individual Corporate OfficerVice Chair Jan 1, 2025
Corporate DirectorDirector Jan 1, 2025
Tabitha Mendez Individual W-2 Managing EmployeeAd; Jan 1, 2025
OtherAdministrator Jan 1, 2025
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Jan 1, 2025
Michael Saunders Individual Corporate OfficerAssistant Secretary Jan 1, 2025
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Chain home office 5% Or Greater Direct Ownership Interest Jan 1, 2025 100%
Amanda Brady Individual Corporate OfficerAssistant Secretary Jan 1, 2025
Bryan Wright Individual Contracted Managing EmployeeChief Executive Officer Jan 1, 2025
Corporate OfficerChief Executive Officer Jan 1, 2025
OtherChief Executive Officer Jan 1, 2025
Sherrie Sitarik Individual Corporate DirectorDirector Jan 1, 2025
Husam E Eddin Individual Contracted Managing EmployeeMD; Jan 1, 2026
David L Huffman Individual Corporate OfficerAssistant Secretary Jan 1, 2025
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Jan 1, 2025
Mark W.H. Wheeler Individual Contracted Managing EmployeeChief Financial Officer Jan 1, 2023
Corporate OfficerChief Financial Officer Jan 1, 2023
OtherChief Financial Officer Jan 1, 2023
Sandra L Randolph Individual Corporate OfficerSecretary Jan 1, 2025
Corporate DirectorDirector Jan 1, 2025

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 85

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

View all 85

Change-of-ownership history 2

DateEventCounterparty
Jan 1, 2025 Change of OwnershipThis provider was the buyer Adventhealth Hospice Care East FloridaCCN 101539, FL, NPI 1801990429
Jan 1, 2025 Change of OwnershipThis provider was the seller Adventhealth HospiceCCN 101539, FL, NPI 1801990429

Practitioners & affiliated clinicians

Affiliated clinicians 20

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735776000000",
    "number": "1801990429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 304",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745180",
            "telephone_number": "386-671-2138",
            "fax_number": "386-672-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 W GRANADA BLVD STE 304",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745180",
            "telephone_number": "386-671-2138",
            "fax_number": "386-672-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTHEALTH HOME HEALTH AND HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A",
        "authorized_official_last_name": "WHEELER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "530-545-1409"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "315D00000X",
            "taxonomy_group": "",
            "desc": "Hospice, Inpatient",
            "state": "FL",
            "license": "5039096",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "592951991010",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "U38",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150003100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVENTHEALTH HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ADVENTHEALTH HOSPICE CARE EAST FLORIDA",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Florida Hospital Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEMORIAL HOSPITAL FLAGLER INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.