NPIMap

Organization Active NPI

Auburn Crest Hospice, LLC

  • Community Based Hospice Care Agency
  • Hayden, ID
National Provider Identifier
1811170236
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
AUBURN CREST HOSPICE, LLC
Practice address
8382 N Wayne Dr Ste 205
Hayden, ID 83835-6028
Phone
(208) 665-8111
Fax
(208) 665-8112
NPI assigned
Dec 7, 2007
Last updated
Aug 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Mr. Jason Fletcher
Title
President
Phone
(208) 376-7298

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X NU Primary

Addresses

Primary practice location

8382 N Wayne Dr Ste 205
Hayden, ID 83835-6028

Mailing address

PO Box 1176
Meridian, ID 83680-1176
Phone (208) 376-7298

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080506000872 ID Part A Provider - Hospice 5496834194 Practice locations: Coeur D Alene, ID

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811170236. Details of each certification follow.

Hospice certification: CCN 131559

Legal name
AUBURN CREST HOSPICE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 5, 2008
Last certification
Oct 31, 2009
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Oct 31, 2007 in ID
Enrollment address
1221 W Ironwood Dr
Ste 102
Coeur D Alene, ID 83814-1402

Care Compare: Hospice

Medicare Care Compare
Listed as
Auburn Crest HospiceCCN 131559 · All quality measures
Ownership
For-Profit
Certified
Dec 5, 2008
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2046431Auburn Crest Hospice8382 N Wayne Dr Ste 205, Hayden, ID 83835Certificate of waiverSep 3, 2026

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1221 W Ironwood Dr
Coeur D Alene, ID 83814

1596 E Seltice Way
Post Falls, ID 83854
Phone (208) 773-7731

1810 E Schneidmiller Ave
Ste 140
Post Falls, ID 83854
Phone (208) 773-7731

1027 Blue Lakes Blvd
#2
Twin Falls, ID 83301
Phone (208) 735-7450

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Keith C Fletcher Individual 5% Or Greater Indirect Ownership Interest Oct 25, 2007 16.32%
Michael Haycraft Individual Operational/Managerial ControlPresident Aug 1, 2022
Elizabeth Fletcher Individual 5% Or Greater Indirect Ownership Interest Dec 30, 2013 22%
CBKM Investments Organization, Nampa, ID LLC 5% Or Greater Indirect Ownership Interest Nov 1, 2014 5%
Heidi Gliddens Individual Operational/Managerial ControlAdministrator Feb 1, 2024
Jason R Fletcher Individual Contracted Managing EmployeePresident Aug 15, 2014 100%
5% Or Greater Indirect Ownership InterestPresident Sep 1, 2008 32.15%
Michael Lee Oglesbay Individual Corporate DirectorMedical Director Oct 18, 2023
Florence E Fletcher Individual 5% Or Greater Indirect Ownership Interest Oct 25, 2007 15.3%
Kameron Ann Lemon Individual 5% Or Greater Indirect Ownership Interest Nov 1, 2014 14.23%
Fletcher Investments, LP Organization, Nampa, ID LLC 5% Or Greater Indirect Ownership Interest Oct 27, 2007 51%
Elson Capital Group, LLC Organization, Eagle, ID LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2014 44%
Synergy Healthcare Holdings LLC Organization, Boise, ID For-profit 5% Or Greater Direct Ownership Interest Apr 21, 2008 100%

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 4

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

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 8

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

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1811170236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1176",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836801176",
            "telephone_number": "208-376-7298",
            "fax_number": "208-377-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8382 N WAYNE DR STE 205",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838356028",
            "telephone_number": "208-665-8111",
            "fax_number": "208-665-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN CREST HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "FLETCHER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-376-7298",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayden, ID

Sources for this page

Verify at the official NPI Registry.