Hospice Advantage, LLC

Organization Active NPI Hospice and Palliative Medicine (Family Medicine) Physician · Tulsa, OK

NPI 1962090654 · NPPES record last updated Mar 30, 2023

Key facts

NPI
1962090654
Entity type
Organization (NPI type 2)
Primary specialty
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X
Legal business name
HOSPICE ADVANTAGE, LLC
Practice address
4612 S Harvard Ave Ste E
Tulsa, OK 74135-2931
Phone
(918) 770-7687
Fax
(918) 592-4110
NPI assigned
Jan 7, 2021
Organization subpart
No

Authorized official

Name
Russell Adkins
Title
SVP Chief Legal Officer
Phone
(615) 309-5668

Corporate family (same tax ID) 36

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

View all 36

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 5

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Compassus-Florence
Florence, AL · CCN 011678
Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Compassus- North Georgia II
East Ellijay, GA · CCN 111682
Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 7, 2015
Compassus - Auburn
Auburn, AL · CCN 011528
Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210419001955 OK Part B Supplier - Clinic/Group Practice 3779544960 Receives reassigned benefits from 4 practitioners
Practice locations: Tulsa, OK

National Provider Directory

Tax ID family
Hospice Advantage LLC (37 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207QH0002X Yes
Hospice and Palliative Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RH0002X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

4612 S Harvard Ave Ste E
Tulsa, OK 74135-2931

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (615) 377-7022

Other names

  • Compassus - Owasso Doing business as

Other providers in Tulsa, OK

All providers in Tulsa, OK · Hospice and Palliative Medicine (Family Medicine) Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.