NPIMap

Organization Active NPI

Ministry Research Inc

Doing business as Islands Hospice

  • Community Based Hospice Care Agency
  • Honolulu, HI
National Provider Identifier
1891940227
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MINISTRY RESEARCH INC
Doing business as
Islands Hospice
Practice address
560 N Nimitz Hwy Ste 204
Honolulu, HI 96817-5330
Phone
(808) 550-2552
Fax
(808) 550-2551
NPI assigned
Nov 26, 2008
Last updated
Jun 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Mark Borneleit
Title
Director
Phone
(808) 372-6336

Specialties & licenses 1

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

Addresses

Primary practice location

560 N Nimitz Hwy Ste 204
Honolulu, HI 96817-5330

Mailing address

3220 S Peoria Ave Ste 101
Tulsa, OK 74105-2006
Phone (808) 372-6336

Other names 1

  • Islands Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090812000687 HI Part A Provider - Hospice 1254494172 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Honolulu, HI; Kahului, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891940227. Details of each certification follow.

Hospice certification: CCN 121509

Legal name
ISLANDS HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 26, 2009
Last certification
Nov 26, 2009
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Sep 23, 2009 in OK
Enrollment address
820 Mililiani St
Ste 400
Honolulu, HI 96813-2934

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospice

Medicare Care Compare
Listed as
Islands HospiceCCN 121509 · All quality measures
Ownership
Non-Profit
Certified
Nov 26, 2009
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Grace Hospice3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

560 N Nimitz Hwy
Ste 204
Honolulu, HI 96817
Phone (808) 550-2552

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Nicole R Smith Individual Corporate DirectorC&L Administrator May 18, 2021
Operational/Managerial ControlC&L Administrator May 18, 2021
Aden 201701, LLC Organization, San Diego, CA LLC 5% Or Greater Direct Ownership Interest May 18, 2021 100%
Christopher Lackner Individual Corporate OfficerSecretary/VP May 18, 2021 100%
Corporate DirectorVP/Secretary Feb 1, 2019 100%
Operational/Managerial Control Feb 1, 2019
Kevin Michael Webb Individual Corporate OfficerPresident May 18, 2021 100%

Practitioners & affiliated clinicians

Affiliated clinicians 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1891940227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 S PEORIA AVE STE 101",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741052006",
            "telephone_number": "808-372-6336",
            "fax_number": "808-356-1973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N NIMITZ HWY STE 204",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968175330",
            "telephone_number": "808-550-2552",
            "fax_number": "808-550-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINISTRY RESEARCH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "BORNELEIT",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "808-372-6336"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Islands Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

Verify at the official NPI Registry.