Loyal Hospice & Palliative Care, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LOYAL HOSPICE & PALLIATIVE CARE, LLC

Doing business as

Serenity Hospice

Practice address

5059 S Lakewood Rd
Fort Mohave, AZ 86426-6501

Phone

(928) 278-4354

Fax

(928) 447-0443

NPI assigned

Feb 8, 2021

Last updated

Jul 12, 2024By 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

John P Hassett

Title

Ceo

Phone

(928) 788-0027

Specialties & licenses 1

Addresses

Other names 1

• Serenity Hospice Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1841882198. Details of each certification follow.

• CCN 031746 Hospice · Active · Details

Hospice certification: CCN 031746

Legal name

LOYAL HOSPICE & PALLIATIVE CARE, LLC

Doing business as

SERENITY HOSPICE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 27, 2021

Last certification

Aug 27, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Feb 9, 2021 in AZ

Enrollment address

5059 S Lakewood Rd
Fort Mohave, AZ 86426-6501

Listed as

Serenity HospiceCCN 031746 · All quality measures

Ownership

For-Profit

Certified

Aug 27, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Loyal Hospice Palliative Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Loyal Hospice & Palliative Care, LLC

  dba Serenity Home Health

  • Home Health Agency
  • Fort Mohave, AZ
  • NPI 1154002889
  NPD tax ID

All disclosed owners & managing parties 9

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 3

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

• Ammar Kafa, M.D.

  • Family Medicine Physician
  • Bullhead City, AZ
  • NPI 1770553737

  Contracted Managing Employee

  CMS ownership
• Koruon Daldalyan, M.D.

  • Internal Medicine Physician
  • Sherman Oaks, CA
  • NPI 1679937643

  Contracted Managing Employee

  CMS ownership
• Jordan Aaron Fisher, MD

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1477013126

  Contracted Managing Employee

  CMS ownership

Practitioners 1

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.

• Koruon Daldalyan, M.D.

  • Internal Medicine Physician
  • Sherman Oaks, CA
  • NPI 1679937643
  NPD

Affiliated clinicians 2

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

• Kyle Murray, D.O.

  • Emergency Medicine Physician
  • Sedona, AZ
  • NPI 1831455401

  Hospice

  Care Compare affiliation
• Jordan Aaron Fisher, MD

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1477013126

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1841882198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5059 S LAKEWOOD RD",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864266501",
            "telephone_number": "928-278-4354",
            "fax_number": "928-447-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5059 S LAKEWOOD RD",
            "city": "FORT MOHAVE",
            "state": "AZ",
            "postal_code": "864266501",
            "telephone_number": "928-278-4354",
            "fax_number": "928-447-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOYAL HOSPICE & PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2024-07-12",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "HASSETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-788-0027"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lexar Transit LLC
• Henry H Liang, D.O.
• Tianning Liu, PHARM.D
• Kenneth Dudley Locke, DO
• Loyal Hospice & Palliative Care, LLC (Serenity Home Health)
• Kristine Luna, NP
• Khushwant Singh Mangat, MD
• Theresa Marin, NP
• Carlos A Martinez
• Cliffard D Mayo, MBA, MS, LAC

• Community Based Hospice Care Agency in Fort Mohave, AZ
• Providers in Fort Mohave, AZ by specialty
• Community Based Hospice Care Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.