Willows Holdings LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

WILLOWS HOLDINGS LLC

Doing business as

The Willows Hospice

Practice address

9150 E 109TH Ave Ste 3a
Crown Point, IN 46307-7686

Phone

(219) 332-5101

Fax

(219) 332-5103

NPI assigned

Jun 9, 2025

Last updated

Sep 2, 2025By 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

Maryann Burk, RN

Title

Ceo

Phone

(219) 743-4365

Specialties & licenses 1

Addresses

Other names 1

• The Willows Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841184371. Details of each certification follow.

• CCN 151673 Hospice · Active · Details

Hospice certification: CCN 151673

Legal name

WILLOWS HOLDINGS LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jan 16, 2026

Last certification

Jan 16, 2026

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Enrollment address

9150 E 109TH Ave
Ste 3a
Crown Point, IN 46307-7686

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

CLIA laboratory certificates

All disclosed owners & managing parties 2

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.

• Brent A Jacobus, D.O.

  • Family Medicine Physician
  • Crown Point, IN
  • NPI 1902807589

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Brent A Jacobus, D.O.

  • Family Medicine Physician
  • Crown Point, IN
  • NPI 1902807589

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1841184371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 3A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-332-5101",
            "fax_number": "219-332-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9150 E 109TH AVE STE 3A",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463077686",
            "telephone_number": "219-332-5101",
            "fax_number": "219-332-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOWS HOLDINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-09-02",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "BURK",
        "authorized_official_first_name": "MARYANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "219-743-4365",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Willows Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karlysia Williams
• Kelly A Williams, MSN - FNP-C
• Octavia Williams
• Theressa Williams, COTA
• Annette Jean Williamson, DDS
• Alexandra Helen Wilson, M.D.
• Bianca Ardenia Wilson, CD(DONA)
• Chyrl Wilson, PSYD, HSPP
• Domonique N Wilson, FNP-BC
• Michael Wilson

• Community Based Hospice Care Agency in Crown Point, IN
• Providers in Crown Point, IN by specialty
• Community Based Hospice Care Agency in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.