Heartland Hospice Services LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2005 Issued in WI

Legal business name

HEARTLAND HOSPICE SERVICES LLC

Doing business as

Heartland Home Health Care and Hospice
ProMedica Hospice (Green Bay)
ProMedica Hospice (Steven's Point)

Practice address

1145 W Main Ave Ste 205
De Pere, WI 54115-1698

Phone

(920) 436-9380

Fax

(920) 436-6608

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 3

• Heartland Home Health Care and Hospice Doing business as
• ProMedica Hospice (Green Bay) Doing business as
• ProMedica Hospice (Steven's Point) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Odyssey Healthcare Holding Company

  dba Heartland Hospice (Green Bay)

  • Community Based Hospice Care Agency
  • De Pere, WI
  • NPI 1366143810

  Sold to, 2023-11-01

  CMS change of ownership

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1851336358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 W MAIN AVE STE 205",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541151698",
            "telephone_number": "920-436-9380",
            "fax_number": "920-436-6608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3233A Business Park Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544828861",
            "country_code": "US",
            "telephone_number": "715-344-4541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43189200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Home Health Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heartland Home Health Care and Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Green Bay)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ProMedica Hospice (Steven's Point)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristel Lyn Hawley, LPC
• Savanna Joy Hayes, LCSW
• Ashleigh Hayward, M.S.CCC-SLP
• Healthy Teeth Green Bay SC
• Heartland Home Care LLC (Heartland Home Health Care)
• Heartland Hospice Services, LLC (ProMedica Hospice (Green Bay))
• Kristen Hebbard
• Heintzkill Chiropractic Plus LLC
• Samuel Alan Heling, LAT
• Carolyn Jean Hendricks, M.D.

• Community Based Hospice Care Agency in De Pere, WI
• Providers in De Pere, WI by specialty
• Community Based Hospice Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.