Organization Active NPI

Haslup Hospice Enterprises, LTD

  • Community Based Hospice Care Agency
  • Virginia Beach, VA
National Provider Identifier
1932401494
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HASLUP HOSPICE ENTERPRISES, LTD
Doing business as
Interim HealthCare Hospice & Palliative Care
Interim Hospice & Pallative Care
Practice address
516 S Independence Blvd Ste 106
Virginia Beach, VA 23452-1153
Phone
(757) 466-1401
Fax
(757) 466-8223
NPI assigned
Dec 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
David N. Haslup
Title
President
Phone
(434) 295-5501

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X
Community Based Hospice Care Agency 251G00000X VA Primary

Addresses

Primary practice location

516 S Independence Blvd Ste 106
Virginia Beach, VA 23452-1153

Mailing address

103 S Pantops Dr
Suite 205
Charlottesville, VA 22911-8617
Phone (434) 295-5501

Other identifiers 7

IdentifierTypeStateIssuer
0087041718MedicaidVA
0087025190MedicaidVA
1073530846OtherVANPI
0087731656MedicaidVA
1225068190OtherVANPI
1073530846MedicaidVA
0087710577MedicaidVA

Other names 2

  • Interim HealthCare Hospice & Palliative Care Doing business as
  • Interim Hospice & Pallative Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190226000617 VA Part A Provider - Hospice 6800135484 Practice locations: Newport News, VA; Virginia Beach, VA
O20220824000476 VA Part B Supplier - Clinic/Group Practice 6800135484 Receives reassigned benefits from 1 practitioner
Practice locations: Virginia Beach, VA

Hospice certification: CCN 491603

Legal name
HASLUP HOSPICE ENTERPRISES LTD
Doing business as
INTERIM HEALTHCARE HOSPICE & PALLIATIVE CARE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 21, 2011
Last certification
Feb 27, 2020
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Oct 1, 2018 in VA
Enrollment address
516 S Independence Blvd
Ste 106
Virginia Beach, VA 23452-1153

Care Compare: Hospice

Medicare Care Compare
Listed as
Interim Healthcare Hospice & Palliative CareCCN 491603
Ownership
For-Profit
Certified
Jul 21, 2011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Haslup Hospice Enterprises LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

707 Westwood Office Park
Fredericksburg, VA 22401
Phone (540) 372-3890

3920 Plank Rd
Fredericksburg, VA 22407
Phone (540) 735-7112

703 Thimble Shoals Blvd
Ste B-2
Newport News, VA 23606
Phone (757) 644-6820

244 Rolla Mill Rd
Verona, VA 24482
Phone (540) 885-4413

516 S Independence Blvd
Ste 106
Virginia Beach, VA 23452
Phone (757) 466-1401

516 S Independence Blvd
Ste 107
Virginia Beach, VA 23452
Phone (757) 524-4027

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Benjamin Frederick Haslup Individual 5% Or Greater Indirect Ownership Interest Jul 1, 2021 10%
Elizabeth H Donaldson Individual 5% Or Greater Indirect Ownership InterestChief Operating Officer Jul 1, 2021 30%
Ivan Monev Individual Operational/Managerial ControlAdministrator / VP Apr 3, 2024
Haslup Holdings LTD Organization, Charlottesville, VA Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Oct 1, 2018 100%
David Nagle Haslup Individual 5% Or Greater Indirect Ownership InterestPresident Jul 1, 2021 60%
Corporate OfficerPresident/Treasurer Oct 1, 2018
Corporate DirectorPresident/Treasurer Oct 1, 2018
W-2 Managing EmployeePresident/Treasurer Oct 1, 2018
Operational/Managerial ControlPresident/Treasurer Oct 1, 2018

Facilities with the same owner 2

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

Change-of-ownership history 2

DateEventCounterparty
Oct 1, 2018 Change of OwnershipThis provider was the buyer Interim HealthcareCCN 491603, VA, NPI 1932401494
Oct 1, 2018 Change of OwnershipThis provider was the seller Interim Healthcare Hospice & Palliative CareCCN 491603, VA, NPI 1932401494

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1932401494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S PANTOPS DR",
            "address_2": "SUITE 205",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118617",
            "telephone_number": "434-295-5501",
            "fax_number": "434-295-4938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S INDEPENDENCE BLVD STE 106",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521153",
            "telephone_number": "757-466-1401",
            "fax_number": "757-466-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASLUP HOSPICE ENTERPRISES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "HASLUP",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-295-5501"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087041718",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087025190",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1073530846",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087731656",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1225068190",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073530846",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0087710577",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Interim HealthCare Hospice & Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Interim Hospice & Pallative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.