NPIMap

Organization Active NPI

Home Town Health Care LLC

Doing business as Home Town Hospice

  • Community Based Hospice Care Agency
  • Independence, KS
National Provider Identifier
1982075693
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HOME TOWN HEALTH CARE LLC
Doing business as
Home Town Hospice
Practice address
921 W Myrtle St
Independence, KS 67301-3241
Phone
(620) 332-3215
Fax
(620) 332-3293
NPI assigned
Oct 8, 2015
Last updated
Apr 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

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

Authorized official

Name
Mrs. Debra Rae Shinkle, RN
Title
Cheif Executive Officer
Phone
(620) 378-3760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X KS Primary

Addresses

Primary practice location

921 W Myrtle St
Independence, KS 67301-3241

Mailing address

314 N 7TH St
Fredonia, KS 66736-1337
Phone (620) 378-3760

Other practice location 1

715 Washington St Ste A
Lyndon, KS 66451-9870
Phone (785) 310-0001

Other identifiers 1

IdentifierTypeStateIssuer
200425730CMedicaidKS

Other names 1

  • Home Town Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160223000362 KS Part A Provider - Hospice 3375544703 Practice locations: Lyndon, KS; Independence, KS

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1982075693. Details of each certification follow.

Hospice certification: CCN 171586

Legal name
HOME TOWN HEALTH CARE LLC
Doing business as
HOME TOWN HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 6, 2012
Last certification
Jan 10, 2025
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Dec 6, 2006 in KS
Enrollment address
921 W Myrtle St
Independence, KS 67301-3241

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Home Town HospiceCCN 171586 · All quality measures
Ownership
Government
Certified
Dec 6, 2012
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
17D2259961Home Town Hospice921 W Myrtle Street, Suite B, Independence, KS 67301Certificate of waiverMay 11, 2028

National Provider Directory

National Provider Directory
Tax ID family
Home Town Health Care7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

921 W Myrtle St
Independence, KS 67301
Phone (620) 331-2725

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Debra R. Shinkle Individual 5% Or Greater Direct Ownership InterestCo-Owner/Administrator Dec 1, 2006 50%
Corporate DirectorAdministrator Oct 11, 2015
Operational/Managerial ControlAdministrator Oct 11, 2015
OtherAdministrator Oct 11, 2015
Bobby R Shinkle Individual 5% Or Greater Direct Ownership InterestCo-Owner Dec 1, 2006 50%

Practitioners & affiliated clinicians

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": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1982075693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 N 7TH ST",
            "city": "FREDONIA",
            "state": "KS",
            "postal_code": "667361337",
            "telephone_number": "620-378-3760",
            "fax_number": "620-378-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W MYRTLE ST",
            "city": "INDEPENDENCE",
            "state": "KS",
            "postal_code": "673013241",
            "telephone_number": "620-332-3215",
            "fax_number": "620-332-3293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Washington St Ste A",
            "address_purpose": "LOCATION",
            "city": "Lyndon",
            "state": "KS",
            "postal_code": "664519870",
            "country_code": "US",
            "telephone_number": "785-310-0001",
            "fax_number": "785-828-3318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOME TOWN HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "SHINKLE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CHEIF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "620-378-3760",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "KS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200425730C",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Home Town Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Home Town Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, KS

Sources for this page

Verify at the official NPI Registry.