Serenity Hospice Care, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SERENITY HOSPICE CARE, LLC

Practice address

W175N11117 Stonewood Dr
Suite 100
Germantown, WI 53022-6508

Phone

(262) 735-4297

NPI assigned

Jan 26, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Tina Thull, RN, BSN

Title

Owner

Phone

(262) 735-4297

Specialties & licenses 1

Addresses

Other names 1

• Grace Hospice Care, LLC Former legal business name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Great Lakes Healthcare, Inc.

  • Community Based Hospice Care Agency
  • Germantown, WI
  • NPI 1619532132

  Sold to, 2019-06-01

  CMS change of ownership

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

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1992076608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W175N11117 STONEWOOD DR",
            "address_2": "SUITE 100",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226508",
            "telephone_number": "262-735-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W175N11117 STONEWOOD DR",
            "address_2": "SUITE 100",
            "city": "GERMANTOWN",
            "state": "WI",
            "postal_code": "530226508",
            "telephone_number": "262-735-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY HOSPICE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-735-4297",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Hospice Care, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dustin Schwobe
• Anthony Scott
• Rebekah Jo Scott, PH.D., LP
• Morgan Segrin, PT, DPT, CLT
• Serene Solutions LLC
• Ryan Sershon, LCSW
• Darci Shook-Woolley, PSY.D.
• Alan H Siggelkow, LCSW
• Rebecca Lynn Sigourney-Tennyck, MD
• Jamie W Simon, FNP, APNP

• Community Based Hospice Care Agency in Germantown, WI
• Providers in Germantown, WI by specialty
• Community Based Hospice Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.