Statim Care Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

STATIM CARE HOSPICE, INC.

Practice address

21243 Ventura Blvd Ste 110
Woodland Hills, CA 91364-2123

Phone

(818) 570-1670

NPI assigned

Aug 6, 2020

Last updated

Dec 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Holmes

Title

Ceo

Phone

(818) 570-1670

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811507528. Details of each certification follow.

• CCN B31795 Hospice · Active · Details

Hospice certification: CCN B31795

Legal name

STATIM CARE HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 29, 2022

Last certification

Apr 29, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

May 26, 2020 in CA

Enrollment address

21243 Ventura Blvd
Ste 110
Woodland Hills, CA 91364-2123

Listed as

Statim Care Hospice, IncCCN B31795 · All quality measures

Certified

Apr 29, 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.

• Audra Elaine Ford, MD, MA

  • Family Medicine Physician
  • Bethesda, MD
  • NPI 1346464286

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Audra Elaine Ford, MD, MA

  • Family Medicine Physician
  • Bethesda, MD
  • NPI 1346464286

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1811507528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21243 VENTURA BLVD STE 110",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642123",
            "telephone_number": "818-570-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21243 VENTURA BLVD STE 110",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913642123",
            "telephone_number": "818-570-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATIM CARE HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-570-1670"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry James Stark, PH.D.
• Genny Starke
• Timothy Starr, MPT
• Robert J. Starzak, MD
• Victoria Camille-Mari Staten
• Stealth Imaging
• Kristina Marie Stebbins
• Thomas Steck
• Tessa Sonja Stecker, MD
• Shakari Steele

• Community Based Hospice Care Agency in Woodland Hills, CA
• Providers in Woodland Hills, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.