NPIMap

Organization Active NPI

Connected Healthcare, Inc.

Doing business as Signature Healthcare at Home

  • Community Based Hospice Care Agency
  • Tigard, OR
National Provider Identifier
1871972224
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
161065 Issued in OR
Legal business name
CONNECTED HEALTHCARE, INC.
Doing business as
Signature Healthcare at Home
Practice address
7632 SW Durham Rd Ste 130
Tigard, OR 97224-7584
Phone
(503) 261-8599
Fax
(503) 408-8922
NPI assigned
May 19, 2015
Last updated
Feb 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

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

Authorized official

Name
Amber Tueller
Title
Secretary
Phone
(208) 207-2726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 161065 OR Primary

Addresses

Primary practice location

7632 SW Durham Rd Ste 130
Tigard, OR 97224-7584

Mailing address

7632 SW Durham Rd Ste 130
Tigard, OR 97224-7584
Phone (503) 261-8599

Other practice location 1

1220 20th St SE Ste 115
Salem, OR 97302-1798
Phone (503) 360-1213

Other names 1

  • Signature Healthcare at Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121009000533 OR Part A Provider - Hospice 9830350412 Practice locations: Salem, OR; Tigard, OR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871972224. Details of each certification follow.

Hospice certification: CCN 381563

Legal name
CONNECTED HEALTHCARE, INC.
Doing business as
SIGNATURE HEALTHCARE AT HOME
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 16, 2016
Last certification
Mar 16, 2016
Ownership / control type
Proprietary - Individual
Organization structure
CorporationProprietary
Enrollment address
7632 SW Durham Rd
Ste 130
Tigard, OR 97224-7584

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Hospice

Medicare Care Compare
Listed as
Signature Healthcare at HomeCCN 381563 · All quality measures
Ownership
For-Profit
Certified
Mar 16, 2016
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
38D2120773Connected Healthcare, Inc Dba1220 20TH St SE, Ste 135, Salem, OR 97302Certificate of waiverOct 23, 2026

National Provider Directory

National Provider Directory
Tax ID family
Connected Healthcare Inc2 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.

Locations

1220 20th St SE
Ste 115
Salem, OR 97302
Phone (503) 360-1213

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
James Arp Individual W-2 Managing EmployeeAd; Mar 13, 2026
Cornerstone Healthcare Inc Organization, Eagle, ID Corporation 5% Or Greater Direct Ownership Interest Apr 13, 2015 100%
Brent Mills Individual Corporate OfficerTreasurer Mar 25, 2026
Brent Guerisoli Individual Corporate DirectorDirector & Sole Board Member Sep 29, 2022
The Pennant Group Inc Organization, Eagle, ID Corporation, For-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2019 100%
Carma Lee Individual Contracted Managing EmployeeMD; Mar 1, 2025
John J Gochnour Individual Corporate OfficerPresident Sep 26, 2024
Amber Tueller Individual Corporate OfficerSecretary Sep 26, 2024

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 141

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

View all 141

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1431993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738886400000",
    "number": "1871972224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7632 SW DURHAM RD STE 130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247584",
            "telephone_number": "503-261-8599",
            "fax_number": "503-408-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7632 SW DURHAM RD STE 130",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972247584",
            "telephone_number": "503-261-8599",
            "fax_number": "503-408-8922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 20th St SE Ste 115",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "OR",
            "postal_code": "973021798",
            "country_code": "US",
            "telephone_number": "503-360-1213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONNECTED HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-19",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "TUELLER",
        "authorized_official_first_name": "AMBER",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "208-207-2726"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OR",
            "license": "161065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Signature Healthcare at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tigard, OR

Sources for this page

Verify at the official NPI Registry.