NPIMap

Organization Active NPI

Hospice Advantage, LLC

Doing business as Compassus - Owasso

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Tulsa, OK
National Provider Identifier
1962090654
Registry record updated Mar 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
HOSPICE ADVANTAGE, LLC
Doing business as
Compassus - Owasso
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
Last updated
Mar 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2023

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X Primary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X

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 1

  • Compassus - Owasso Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

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

National Provider Directory
Tax ID family
Hospice Advantage LLC37 organizations share this tax ID, including this one

Other organizations with this 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.

Ownership & related parties

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-FlorenceFlorence, AL, CCN 011678 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Compassus- North Georgia IIEast Ellijay, GA, CCN 111682 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 7, 2015
Compassus - AuburnAuburn, AL, CCN 011528 Hospice 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1962090654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "615-377-7022",
            "fax_number": "615-373-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 S HARVARD AVE STE E",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352931",
            "telephone_number": "918-770-7687",
            "fax_number": "918-592-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPICE ADVANTAGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "615-309-5668"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus - Owasso",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Compassus - Owasso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.