Cornerstone Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

4146 Issued in OK

Legal business name

CORNERSTONE HOSPICE LLC

Doing business as

Cornerstone Hospice of Tulsa

Practice address

501 E 5TH St Ste a
Bartlesville, OK 74003-3942

Phone

(918) 213-4973

NPI assigned

Aug 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael Brent Moore, R PH DNPI 1720122336

Title

Owner/President

Phone

(918) 213-4973

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cornerstone Hospice of Tulsa Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Hospice certification: CCN 371606

Legal name

CORNERSTONE HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Aug 7, 2002

Last certification

Mar 31, 2022

Ownership / control type

Proprietary - Individual

Organization structure

LLCProprietary

Enrollment address

501 E 5TH Street
Suite a
Bartlesville, OK 74003

Listed as

Cornerstone Hospice of TulsaCCN 371606 · All quality measures

Ownership

For-Profit

Certified

Aug 7, 2002

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 2

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

Owners & managing parties with NPI records 1

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

• John W Hatchett, M.D.

  • Specialist
  • Bartlesville, OK
  • NPI 1366503930

  W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Brent Moore, D.PH.

  • Pharmacist
  • Bartlesville, OK
  • NPI 1720122336
  NPD Authorized official

Affiliated clinicians 1

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

• Kyle D Craig, MD

  • Family Medicine Physician
  • Bartlesville, OK
  • NPI 1528138633

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1922009315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E 5TH ST STE A",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033942",
            "telephone_number": "918-213-4973",
            "fax_number": "918-213-4989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E 5TH ST STE A",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740033942",
            "telephone_number": "918-213-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "918-213-4973",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R PH D"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "4146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "371606",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Hospice of Tulsa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cornerstone Hospice of Tulsa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jerusha Marie Coward, PHARM.D.

• Community Based Hospice Care Agency in Bartlesville, OK
• Providers in Bartlesville, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.

Verify at the official NPI Registry.