Active NPI
Livingston Memorial Visiting Nurse Association
- Community Based Hospice Care Agency
- Ventura, CA
National Provider Identifier
1881698447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 070000576
- Legal business name
- LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION
- Practice address
- 1996 Eastman Ave
Ste 101
Ventura, CA 93003-5768 - Phone
- (805) 642-0239
- Fax
- (805) 642-7402
- NPI assigned
- Jun 10, 2005
- Organization subpart
- Yes
- Parent organization
- LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Teresa Pavan
- Title
- Director/Coo
- Phone
- (805) 642-0239
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 070000576 | CA | Primary |
Addresses
Primary practice location
1996 Eastman Ave
Ste 101
Ventura, CA 93003-5768
Mailing address
1996 Eastman Ave Ste 108
Ventura, CA 93003-5769
Phone (805) 642-0239
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 051517 | Other | CA | BLUE CROSS HOSPICE PROVID |
| ZZZ02348Z | Other | CA | BLUE SHIELD PROVIDER NO |
| 1881698447 | Medicaid | CA |
Other names 2
- Livingston Memorial VNA Hospice
- Livingston Memorial Visiting Nurse Association & Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110708000319 | CA | Part A Provider - Hospice | 7618091067 | Practice locations: Camarillo, CA; Ojai, CA; Ventura, CA |
Hospice certification: CCN 051517
- Legal name
- LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION
- Doing business as
- LIVINGSTON MEMORIAL VNA HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 20, 1985
- Last certification
- Jul 27, 2018
- Ownership / control type
- Non-Profit - Private
- Organization structure
- Corporation
- Incorporated
- Oct 19, 1987 in CA
- Enrollment address
- 1996 Eastman Ave
Ste 108
Ventura, CA 93003-5769
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
7618091067
Care Compare: Hospice
Medicare Care Compare- Listed as
- Livingston Memorial Visiting Nurse Association - H
- Ownership
- Non-Profit
- Certified
- Aug 20, 1985
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Livingston Memorial Visiting Nurse Association
- Part of
- Livingston Memorial Visiting Nurse Association
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
Locations
1996 Eastman Ave
Ste 101
Ventura, CA 93003
Phone (805) 642-0239
Ownership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Maureen a Corbett | Corporate Officer | Aug 30, 2023 | 100% |
| W-2 Managing Employee | Aug 30, 2023 | 100% | |
| William J Kearney | Corporate Director | Sep 9, 2010 | |
| Jamaine Ellen O'Brien | Corporate Officer | Jun 10, 2021 | |
| W-2 Managing Employee | Jun 10, 2021 | 100% | |
| John Fankhauser | Corporate Director | Apr 1, 2019 | |
| Banks Staples Pecht | Corporate Director | Sep 1, 2016 | |
| Ric Ruffinelli | Corporate Director | Apr 1, 2015 | |
| Joan R Araujo | Corporate Director | Jan 1, 2013 | |
| Margo M Byrne | Corporate Director | Feb 23, 2023 | |
| Clarence a Reeves | Corporate Director | Apr 1, 2017 | |
| Robert Cunningham Streeter | Corporate Director | Apr 1, 2017 | |
| Gabriel R Duarte | Corporate Director | Feb 23, 2023 | |
| Livingston Memorial Visiting Nurse Association | 5% Or Greater Direct Ownership Interest | Oct 19, 1987 | 100% |
| Jurgen Gramckow | Corporate Director | May 1, 2013 | |
| Jane Donlon Waters | Corporate Director | Nov 1, 2016 | |
| Laura K McAvoy | Corporate Director | Sep 9, 2010 | |
| Lanyard K Dial | Corporate Director | Feb 18, 2006 | |
| W-2 Managing Employee | Feb 18, 2006 | ||
| Adam Y Thunell | Corporate Director | Oct 1, 2015 |
Owners & managing parties with NPI records 5
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Geriatric Medicine (Internal Medicine) Physician
- Ventura, CA
- NPI 1629131545
Corporate Director, W-2 Managing Employee
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
5% Or Greater Direct Ownership Interest
-
- Geriatric Physical Therapist
- Westlake Village, CA
- NPI 1346181435
Corporate Officer, W-2 Managing Employee
-
- Family Medicine Physician
- Camarillo, CA
- NPI 1154432151
Corporate Director
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Livingston Memorial Vna | Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Oct 19, 1987 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
5% Or Greater Direct Ownership Interest
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
Livingston Memorial Visiting Nurse Association
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Home Health Agency
- Ventura, CA
- NPI 1053315739
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Ventura, CA
- NPI 1427321637
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Ventura, CA
- NPI 1427320480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1649808000000",
"number": "1881698447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1996 EASTMAN AVE STE 108",
"city": "VENTURA",
"state": "CA",
"postal_code": "930035769",
"telephone_number": "805-642-0239",
"fax_number": "805-642-7402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1996 EASTMAN AVE",
"address_2": "STE 101",
"city": "VENTURA",
"state": "CA",
"postal_code": "930035768",
"telephone_number": "805-642-0239",
"fax_number": "805-642-7402"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIVINGSTON MEMORIAL VISITING NURSE ASSOCIATION",
"enumeration_date": "2005-06-10",
"last_updated": "2022-04-13",
"certification_date": "2022-04-13",
"status": "A",
"authorized_official_last_name": "PAVAN",
"authorized_official_first_name": "TERESA",
"authorized_official_title_or_position": "DIRECTOR/COO",
"authorized_official_telephone_number": "805-642-0239",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "CA",
"license": "070000576",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS HOSPICE PROVID",
"identifier": "051517",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD PROVIDER NO",
"identifier": "ZZZ02348Z",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1881698447",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Livingston Memorial VNA Hospice",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Livingston Memorial VNA Hospice",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Livingston Memorial Visiting Nurse Association & Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.
- 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.