Organization Active NPI

Heartland Hospice Services, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Marion, OH
National Provider Identifier
1982347795
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
HEARTLAND HOSPICE SERVICES, LLC
Practice address
685 Delaware Ave Ste 200
Marion, OH 43302-5072
Phone
(740) 382-5442
NPI assigned
Apr 19, 2022
Organization subpart
Yes
Parent organization
HEARTLAND HOSPICE SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Authorized official

Name
Martin David Allen
Title
Sole Director
Phone
(419) 252-5734

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

685 Delaware Ave Ste 200
Marion, OH 43302-5072

Mailing address

PO Box 10086
Toledo, OH 43699-0086
Phone (567) 585-1191

Other identifiers 1

IdentifierTypeStateIssuer
2529615MedicaidOH

Other names 1

  • ProMedica Hospice (Marion) Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Part of
Heartland Hospice-Tulsa

Locations

685 Delaware Ave
Ste 200
Marion, OH 43302
Phone (740) 382-5442

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Eileen M Corwin Individual Contracted Managing EmployeeAdministrator Nov 1, 2003
Terrence G Metzger Individual Corporate OfficerTreasurer Nov 1, 2023
Martin D Allen Individual Corporate DirectorSole Director Sep 30, 2012
Operational/Managerial ControlChain Home Office Administrator Sep 22, 2017
HCR Manor Care Services LLC Organization, Toledo, OH Operational/Managerial Control Dec 21, 2007
HCR Healthcare, LLC Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Dec 21, 2007 100%
Dean Shipman Individual W-2 Managing EmployeeAvp Reimbursement Services May 1, 2016
Kathryn H Hoops Individual Corporate OfficerVice President Nov 7, 2007
Stephen M Sadowski Individual Corporate OfficerSecretary Nov 1, 2023
Justin Skiver Individual Corporate OfficerPresident Aug 29, 2023
Andrea Sype Individual Corporate OfficerVice President Jan 1, 2021
HCR Manorcare, Inc. Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%
HCR Home Health Care and Hospice LLC Organization, Toledo, OH Non-profit 5% Or Greater Direct Ownership Interest Dec 21, 2007 100%
Eric J Talbert Individual Corporate OfficerAssistant Vice President Jun 24, 2013
Promedica Health System Inc Organization, Toledo, OH Non-profit 5% Or Greater Indirect Ownership Interest Jul 26, 2018 100%

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1982347795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 DELAWARE AVE STE 200",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433025072",
            "telephone_number": "740-382-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND HOSPICE SERVICES, LLC",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2529615",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Marion)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.