NPIMap

Organization Active NPI

Residential Hospice of Missouri, LLC

  • Community Based Hospice Care Agency
  • Leawood, KS
National Provider Identifier
1912612482
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
RESIDENTIAL HOSPICE OF MISSOURI, LLC
Practice address
13002 State Line Rd
Leawood, KS 66209-1756
Phone
(913) 905-0255
Fax
(913) 339-9775
NPI assigned
Jan 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Mr. Justin Dewitte
Title
Ceo
Phone
(866) 902-4000

Specialties & licenses 1

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

Addresses

Primary practice location

13002 State Line Rd
Leawood, KS 66209-1756

Mailing address

5440 Corporate Dr Ste 400
Troy, MI 48098-2645
Phone (913) 905-0255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230612001224 KS Part A Provider - Hospice 0244697993 Practice locations: Leawood, KS

Hospice certification: CCN 171627

Legal name
RESIDENTIAL HOSPICE OF MISSOURI, LLC
Doing business as
RESIDENTIAL HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 2, 2024
Last certification
Apr 19, 2024
Organization structure
LLCProprietary
Incorporated
Jul 15, 2022 in MO
Enrollment address
13002 State Line Rd
Leawood, KS 66209-1756

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
Residential HospiceCCN 171627
Certified
May 2, 2024
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Residential Hospice of Missouri LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Graham Health Services, LLC Organization, Troy, MI LLC, For-profit Operational/Managerial Control Jan 1, 2023
Dominic Frank Tutera 2016 Irrv TR Organization, Kansas City, MO 5% Or Greater Indirect Ownership Interest May 2, 2022 8.42%
Continua Holdco, LLC Organization, Troy, MI LLC, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 15, 2022 100%
Karen Sloaf Individual Operational/Managerial ControlDirector of Regulatory Affairs Oct 9, 2025
Residential Kansas Holdco, Inc. Organization, Troy, MI Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 15, 2022 60%
Patricia Hudson Individual W-2 Managing EmployeeAd;Regional VP of Hospice Jan 1, 2023
Cameron Smith Individual Contracted Managing EmployeeMD; Aug 1, 2023
Randall L Bloom Individual 5% Or Greater Indirect Ownership Interest May 2, 2022 6%
Leeann Lang Individual Corporate OfficerSenior VP of Administration Oct 9, 2025
2Tera Investments Limited Partnership Organization, Kansas City, MO For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 2, 2022 34%
Graham Healthcare Group Inc Organization, Troy, MI Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 15, 2022 60%
Laura Cirese Tutera 2016 Irrv TR Organization, Kansas City, MO 5% Or Greater Indirect Ownership Interest May 2, 2022 8.42%
Deedrea Grein Individual Corporate OfficerCeo Dec 1, 2025
Graham Holdings Company Organization, Arlington, VA Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jul 15, 2022 60%
Hannah Marie Tutera 2016 Irrv TR Organization, Kansas City, MO 5% Or Greater Indirect Ownership Interest May 2, 2022 8.42%
Iac Investments, LLC Organization, Kansas City, MO LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest May 2, 2022 40%
Jason Pierce Individual Corporate OfficerCfo Oct 9, 2025
Joseph Charles Tutera Jr 2016 Irrv TR Organization, Kansas City, MO 5% Or Greater Indirect Ownership Interest May 2, 2022 8.42%

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 30

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

View all 30

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1912612482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CORPORATE DR STE 400",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982645",
            "telephone_number": "913-905-0255",
            "fax_number": "913-339-9775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13002 STATE LINE RD",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662091756",
            "telephone_number": "913-905-0255",
            "fax_number": "913-339-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL HOSPICE OF MISSOURI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "DEWITTE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "866-902-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

Verify at the official NPI Registry.