NPIMap

Organization Active NPI

BJC Home Care Services

Doing business as BJC Hospice

  • Community Based Hospice Care Agency
  • Saint Louis, MO
National Provider Identifier
1891705547
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
00010918 Issued in MO
Legal business name
BJC HOME CARE SERVICES
Doing business as
BJC Hospice
Practice address
670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573
Phone
(314) 953-1615
Fax
(314) 273-0704
NPI assigned
Aug 8, 2006
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Angela Martin-Davis
Title
President
Phone
(314) 206-3712

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 00010918 MO Primary

Addresses

Primary practice location

670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573

Mailing address

670 Mason Ridge Center Dr Ste 300
Saint Louis, MO 63141-8573
Phone (314) 953-1615

Other names 1

  • BJC Hospice Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323000801 MO Part A Provider - Hospice 6901716695 Practice locations: Farmington, MO; Saint Louis, MO; Sullivan, MO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891705547. Details of each certification follow.

Hospice certification: CCN 261511

Legal name
BJC HOME CARE SERVICES
Doing business as
BJC HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Aug 15, 1988
Last certification
Mar 25, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Apr 10, 1987 in MO
Enrollment address
301 S Jefferson St
Farmington, MO 63640-2554

Other NPIs with the same Medicare PAC ID 6

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

Care Compare: Hospice

Medicare Care Compare
Listed as
BJC HospiceCCN 261511 · All quality measures
Ownership
Non-Profit
Certified
Aug 15, 1988
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
BJC Home Care Services10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

2220 S State Route 157
Ste 300
Glen Carbon, IL 62034
Phone (618) 463-7100

113 Progress Pkwy
Sullivan, MO 63080
Phone (573) 468-3630

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Susanne Rosenberg Individual Corporate OfficerVice President Jul 31, 2023
W-2 Managing EmployeeVice President Jul 31, 2023
Operational/Managerial ControlVice President Jul 31, 2023
Jennifer Martin Individual W-2 Managing EmployeeAd; Apr 8, 2024
Michele McKee Individual Corporate DirectorBoard Member Jan 1, 2026
Matthew a Broom Individual Corporate DirectorBoard Member Jan 1, 2026
Annette D Schnabel Individual Corporate DirectorBoard Member Jan 1, 2022
Operational/Managerial ControlBoard Member Jan 1, 2022
TSZ Lau Individual W-2 Managing EmployeeAd; Apr 8, 2024
Ann Short Individual W-2 Managing EmployeeAd; Apr 8, 2024
David Braasch Individual Corporate OfficerTreasurer/Secretary Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Operational/Managerial ControlBoard Member Jan 1, 2021
Angelleen Peters-Lewis Individual Corporate DirectorBoard Member Jan 1, 2018
Operational/Managerial ControlBoard Member Jan 1, 2018
BJC Health System Organization, Saint Louis, MO Operational/Managerial Control May 11, 1992
Trisha M Lollo Individual Corporate DirectorBoard Member Mar 15, 2013
Operational/Managerial ControlBoard Member Mar 15, 2013
Angela Martin-Davis Individual Corporate OfficerPresident Jul 12, 2023
Corporate DirectorPresident Jul 12, 2023
W-2 Managing EmployeePresident Jul 12, 2023
Operational/Managerial ControlPresident Jul 12, 2023
Kevin a Journagan Individual Corporate OfficerBoard Member Jan 1, 2026
Corporate DirectorBoard Member Jan 1, 2026
Elizabeth Lawson Individual Corporate OfficerVice President, Finance Jan 1, 2022
Operational/Managerial ControlVice President, Finance Jan 1, 2022
Scott Hawig Individual Corporate OfficerVice President, Finance Jan 1, 2026
Operational/Managerial ControlVice President, Finance Jan 1, 2026
Patrick H White Individual Corporate DirectorBoard Member Jan 1, 2016
W-2 Managing EmployeeMD; Jan 1, 2016
Operational/Managerial ControlBoard Member Jan 1, 2016

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
BJC HospiceGlen Carbon, IL, CCN 141637 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 23, 2011

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 32

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

View all 32

Practitioners & affiliated clinicians

Affiliated clinicians 93

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

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1891705547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-953-1615",
            "fax_number": "314-273-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573",
            "telephone_number": "314-953-1615",
            "fax_number": "314-273-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BJC HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN-DAVIS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-206-3712"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "MO",
            "license": "00010918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1935 Belt Way Dr",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631145825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "BJC Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BJC Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.