NPIMap

Organization Active NPI

Community Nursing Service

  • Community Based Hospice Care Agency
  • Providence, UT
National Provider Identifier
1821046236
Registry record updated Sep 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2014-HOSPICE-69017 Issued in UT
Legal business name
COMMUNITY NURSING SERVICE
Practice address
221 North Gateway Drive
Suite G
Providence, UT 84332-9791
Phone
(435) 752-3355
Fax
(435) 732-1185
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2015

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

Authorized official

Name
Mr. Brent D. Jones
Title
President& Ceo
Phone
(801) 233-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2014-HOSPICE-69017 UT Primary

Addresses

Primary practice location

221 North Gateway Drive
Suite G
Providence, UT 84332-9791

Mailing address

2830 S Redwood Rd
Suite a
West Valley City, UT 84119-5625
Phone (801) 233-6100

Other names 1

  • CNS COMMUNITY HOSPICE, CNS HOSPICE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050113000852 UT Part A Provider - Hospice 9234036674 Practice locations: Brigham City, UT; Providence, UT

Hospice certification: CCN 461553

Legal name
COMMUNITY NURSING SERVICE
Doing business as
CNS COMMUNITY HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Sep 9, 2005
Last certification
Nov 5, 2019
Ownership / control type
Non-Profit - Other
Organization structure
CorporationNon-profit
Incorporated
Dec 29, 1994 in UT
Enrollment address
221N Gateway Dr G
Providence, UT 84332-9791

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Hospice

Medicare Care Compare
Listed as
CNS Community Hospice - ProvidenceCCN 461553
Ownership
Non-Profit
Certified
Sep 9, 2005
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Community Nursing Service5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

221 N Gateway Dr
Ste G
Providence, UT 84332
Phone (435) 752-3355

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Florence Marie Miller Individual Corporate DirectorBoard of Trustees May 1, 2012 100%
David Gessel Individual Corporate DirectorChairman of the Board Apr 17, 2020
Jaimi Ostergar Individual Corporate OfficerVice President Apr 16, 2011
W-2 Managing EmployeeVice President Apr 16, 2011
Steven Leroy Love Individual Corporate OfficerSenior VP Mar 22, 2008
W-2 Managing EmployeeSenior VP Mar 22, 2008
Cherie Pratt Brunker Individual Corporate DirectorBoard of Trustees May 1, 2011 100%
Cody Johnson Individual W-2 Managing EmployeeAd; Aug 16, 2010 100%
Joel Macey Individual Corporate OfficerCeo May 22, 2023 100%
Joshua Love Individual W-2 Managing EmployeePharmacy Director Jul 2, 2007

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1821046236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 S REDWOOD RD",
            "address_2": "SUITE A",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841195625",
            "telephone_number": "801-233-6100",
            "fax_number": "801-233-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NORTH GATEWAY DRIVE",
            "address_2": "SUITE G",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329791",
            "telephone_number": "435-752-3355",
            "fax_number": "435-732-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY NURSING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT& CEO",
        "authorized_official_telephone_number": "801-233-6100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "UT",
            "license": "2014-HOSPICE-69017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CNS COMMUNITY HOSPICE, CNS HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, UT

Sources for this page

Verify at the official NPI Registry.