NPIMap

Organization Active NPI

Good Shepherd Hospice Inc

  • Community Based Hospice Care Agency
  • Oklahoma City, OK
National Provider Identifier
1851493944
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
4038 Issued in OK
Legal business name
GOOD SHEPHERD HOSPICE INC
Practice address
4350 Will Rogers Parkway
Suite 400
Oklahoma City, OK 73108
Phone
(405) 943-0903
Fax
(405) 943-0950
NPI assigned
Sep 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Mr. Jason Kyle Delester
Title
President
Phone
(405) 943-0903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 4038 OK Primary

Addresses

Primary practice location

4350 Will Rogers Parkway
Suite 400
Oklahoma City, OK 73108

Mailing address

4350 Will Rogers Parkway
Suite 400
Oklahoma City, OK 73108
Phone (405) 943-0903

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/SDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040205000896 OK Part A Provider - Hospice 1850208414 Practice locations: Elk City, OK; Hinton, OK; Norman, OK; Oklahoma City, OK; Woodward, OK

Hospice certification: CCN 371538

Legal name
GOOD SHEPHERD HOSPICE INC
Doing business as
GOOD SHEPHERD HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 31, 1995
Last certification
Feb 2, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jul 7, 1999 in OK
Enrollment address
4350 Will Rogers Pkwy
Ste 400
Oklahoma City, OK 73108-1840

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Good Shepherd Hospice, Inc.CCN 371538
Ownership
For-Profit
Certified
Mar 31, 1995
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D0899617Good Shepherd Hospice4350 Will Rogers Parkway, Ste 400, Oklahoma City, OK 73108Certificate of waiverApr 3, 2027

National Provider Directory

National Provider Directory

Locations

3804 Cedar Dr
Colcord, OK 74338
Phone (918) 868-8500

120 S Main St
Elk City, OK 73644
Phone (580) 303-7089

317 N Broadway Ave
Ste 40
Hinton, OK 73047
Phone (405) 519-5865

1818 W Lindsey St
Ste B108
Norman, OK 73069
Phone (405) 928-2777

918 W Choctaw St
Tahlequah, OK 74464
Phone (918) 871-4033

6218 S Lewis Ave
Ste 110
Tulsa, OK 74136
Phone (918) 743-5067

505 E Franklin Ave
Weatherford, OK 73096
Phone (580) 772-0303

2411 Williams Ave
Ste 113
Woodward, OK 73801
Phone (580) 377-3303

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Commodore Revocable Trust Organization, Oklahoma City, OK 5% Or Greater Direct Ownership Interest Mar 25, 2021 10.69%
David Greiner Individual 5% Or Greater Indirect Ownership Interest Dec 31, 2023 8.91%
Kenneth Don Greiner Individual OtherTrustee Feb 19, 2024 10.69%
Jason Kyle Delester Individual Corporate Officer Sep 30, 2005
Corporate Director Jan 11, 2006
W-2 Managing Employee Oct 1, 2005
Dan Neal Waters Individual Contracted Managing EmployeeMD; Jun 20, 2006
Lori Delester Individual 5% Or Greater Indirect Ownership Interest Jan 1, 2023 5.12%
William Griffin Individual 5% Or Greater Direct Ownership Interest Jan 1, 2023 5.12%
Shellie K Greiner Individual 5% Or Greater Indirect Ownership Interest Mar 25, 2021 50.79%
Lori a. Delester 2009 Revocable Trust Organization, Oklahoma City, OK Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jan 1, 2023 5.12%
Safe Harbor Holdings LLC Organization, Oklahoma City, OK LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 25, 2021 8.91%
William Brett Coble Individual 5% Or Greater Direct Ownership Interest Jan 1, 2023 5.12%
Katherine L Pierce Individual 5% Or Greater Direct Ownership InterestAdmin Mar 25, 2021 5.35%
Shellie K Greiner Revocable Trust Organization, Edmond, OK Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 25, 2021 50.79%
Denisha Woodcock Individual W-2 Managing EmployeeAd; Apr 28, 2025 100%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 7

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1851493944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 WILL ROGERS PARKWAY",
            "address_2": "SUITE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73108",
            "telephone_number": "405-943-0903",
            "fax_number": "405-943-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 WILL ROGERS PARKWAY",
            "address_2": "SUITE 400",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73108",
            "telephone_number": "405-943-0903",
            "fax_number": "405-943-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "DELESTER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-943-0903",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/SDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.