Active NPI
Lifecare Hospice
- Hospice and Palliative Medicine (Family Medicine) Physician
- Wooster, OH
National Provider Identifier
1922034701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospice and Palliative Medicine (Family Medicine) Physician
- License
- 34.003501
- Legal business name
- LIFECARE HOSPICE
- Practice address
- 1900 Akron Rd
Wooster, OH 44691-2518 - Phone
- (330) 264-4899
- Fax
- (330) 264-4874
- NPI assigned
- Jun 24, 2006
- Organization subpart
- Yes
- Parent organization
- LIFECARE HOSPICE
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Kurt Holmes
- Title
- Executive Director
- Phone
- (330) 264-4899
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospice and Palliative Medicine (Family Medicine) Physician | 207QH0002X | 34.003501 | OH | Primary |
Addresses
Primary practice location
1900 Akron Rd
Wooster, OH 44691-2518
Mailing address
1900 Akron Rd
Wooster, OH 44691-2518
Phone (330) 264-4899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2831261 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614001154 | OH | Part B Supplier - Clinic/Group Practice | 1052395571 |
Receives reassigned benefits from 10 practitioners Practice locations: Orrville, OH; Rittman, OH; Wadsworth, OH; Walnut Creek, OH; Wooster, OH; Millersburg, OH; Loudonville, OH; Ashland, OH… |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Part of
- Lifecare Hospice
Practitioners & affiliated clinicians
Practitioners 10
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gerontology Nurse Practitioner
- Cleveland, OH
- NPI 1346988607
OH
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Wooster, OH
- NPI 1043491061
Hospice and Palliative Medicine, OH
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1579219200000",
"number": "1922034701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 AKRON RD",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446912518",
"telephone_number": "330-264-4899",
"fax_number": "330-264-4874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 AKRON RD",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446912518",
"telephone_number": "330-264-4899",
"fax_number": "330-264-4874"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFECARE HOSPICE",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LIFECARE HOSPICE",
"enumeration_date": "2006-06-24",
"last_updated": "2020-01-17",
"certification_date": "2020-01-17",
"status": "A",
"authorized_official_last_name": "HOLMES",
"authorized_official_first_name": "KURT",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "330-264-4899",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207QH0002X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Hospice and Palliative Medicine",
"state": "OH",
"license": "34.003501",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2831261",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.