Bluebird Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BLUEBIRD HOSPICE LLC

Practice address

110 S Washington St Ste 200
Oxford, MI 48371-4975

Phone

(248) 264-3704

NPI assigned

Mar 18, 2024

Last updated

Mar 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew Kopmeyer

Title

Owner

Phone

(248) 909-2033

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922867225. Details of each certification follow.

• CCN 231726 Hospice · Active · Details

Hospice certification: CCN 231726

Legal name

BLUEBIRD HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Dec 30, 2024

Last certification

Dec 19, 2024

Ownership / control type

Proprietary - Corporation

Organization structure

LLCProprietary

Incorporated

Jan 12, 2023 in MI

Enrollment address

110 S Washington St
Ste 200
Oxford, MI 48371-4975

Listed as

Bluebird Hospice, LLCCCN 231726 · All quality measures

Certified

Dec 30, 2024

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

Locations

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.

Owners & managing parties with NPI records 1

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

• Jennie Rose, MD

  • Obstetrics & Gynecology Physician
  • Traverse City, MI
  • NPI 1174577977

  W-2 Managing Employee

  CMS ownership

Affiliated clinicians 2

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

• Rachel Maryann Klamo, D.O.

  • Family Medicine Physician
  • Oxford, MI
  • NPI 1497953533

  Hospice

  Care Compare affiliation
• Timothy R Oneill, DO

  • Family Medicine Physician
  • Clarkston, MI
  • NPI 1033117890

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1922867225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S WASHINGTON ST STE 200",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483714975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S WASHINGTON ST STE 200",
            "city": "OXFORD",
            "state": "MI",
            "postal_code": "483714975",
            "telephone_number": "248-264-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUEBIRD HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "KOPMEYER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-909-2033"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Marie Billings, LBSW
• Khrystyna Bilous
• Janine Bishop, LPC
• Konjit A Bitew
• Taylor Parker Blaine
• Kaely Minati Bolio, DDS
• Katrina Marie Both
• Donald Alfred Bourbeau, DDS
• Alana Karie Koepf Bowman, DO
• Erin Box, LLMSW

• Community Based Hospice Care Agency in Oxford, MI
• Providers in Oxford, MI by specialty
• Community Based Hospice Care Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.