Active NPI
Bristol Hospice - Madison, L.L.C.
- Community Based Hospice Care Agency
- Madison, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- BRISTOL HOSPICE - MADISON, L.L.C.
- Practice address
- 206 E Olin Ave Ste 101
Madison, WI 53713-1434 - Phone
- (608) 960-7699
- Fax
- (608) 716-3168
- NPI assigned
- Mar 26, 2021
- Last updated
- Jun 29, 2023
- Organization subpart
- Yes
- Parent organization
- BRISTOL HOSPICE, L.L.C.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Hyrum A Kirton
- Title
- President & Ceo
- Phone
- (801) 325-0175
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
206 E Olin Ave Ste 101
Madison, WI 53713-1434
Mailing address
206 N 2100 W Ste 202
Salt Lake City, UT 84116-4741
Phone (801) 325-0175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220413001827 | WI | Part A Provider - Hospice | 4587050836 | Practice locations: Brookfield, WI; Madison, WI |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1992382733. Details of each certification follow.
Hospice certification: CCN 521613
- Legal name
- BRISTOL HOSPICE - MADISON LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Sep 29, 2022
- Last certification
- Sep 29, 2022
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jan 28, 2021 in DE
- Enrollment address
- 206 E Olin Ave
Ste 101
Madison, WI 53713-1434
Care Compare: Hospice
Medicare Care Compare- Listed as
- Bristol Hospice Madison
- Certified
- Sep 29, 2022
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D2243563 | Bristol Hospice - Madison, LLC | Certificate of waiver | Nov 18, 2027 |
National Provider Directory
National Provider Directory- Part of
- Bristol Hospice LLC
Locations
206 E Olin Ave
#101
Madison, WI 53713
Phone (608) 960-7699
Ownership & related parties
All disclosed owners & managing parties 15
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Bristol Hospice Holdings Inc | 5% Or Greater Indirect Ownership Interest | Jan 28, 2021 | 100% |
| Alex Edward Mauricio | Corporate Officer | Jan 1, 2023 | |
| Corporate Director | Jan 1, 2023 | ||
| Webster Equity Partners Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 25, 2022 | 69.8% |
| John Charles Garbarino | Corporate Officer | Jan 28, 2021 | |
| Corporate Director | Jan 28, 2021 | ||
| Webster Equity Partners IV Bristol CF LP | 5% Or Greater Indirect Ownership Interest | Jan 25, 2022 | 5.72% |
| Michael Derrick | Corporate Officer | Sep 1, 2023 | |
| Corporate Director | Sep 1, 2023 | ||
| Betty J Brennan | Corporate Director | Jul 23, 2018 | |
| Bristol Ultimate Holdco, LP | 5% Or Greater Indirect Ownership Interest | Jan 25, 2022 | 100% |
| Susan E H Ferguson | Contracted Managing Employee | Feb 28, 2026 | |
| Hyrum Kirton | Corporate Director | Oct 26, 2020 | |
| Aware Super Pty, LTD. | 5% Or Greater Indirect Ownership Interest | Jan 24, 2022 | 8.28% |
| Bristol Hospice, L.L.C. | 5% Or Greater Direct Ownership Interest | Jan 28, 2021 | 100% |
| Ally Schauer | W-2 Managing Employee | Aug 28, 2023 | |
| Bristol Hospice Topco Inc | 5% Or Greater Indirect Ownership Interest | Jan 28, 2021 | 100% |
| David a Malm | Corporate Officer | Jan 28, 2021 | |
| Corporate Director | Jan 28, 2021 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Pulmonary Disease Physician
- Madison, WI
- NPI 1215104179
Contracted Managing Employee
Facilities with the same owner 52
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Community Based Hospice Care Agency
- Green Bay, WI
- NPI 1356928154
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bangor, ME
- NPI 1336916469
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Bend, OR
- NPI 1356916845
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Plymouth Meeting, PA
- NPI 1356118467
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Merced, CA
- NPI 1487603452
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- North Charleston, SC
- NPI 1326866963
Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Des Plaines, IL
- NPI 1104548478
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Springfield, OR
- NPI 1568962033
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
- Community Based Hospice Care Agency
- Atlanta, GA
- NPI 1558663872
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Healthcare Services
- Community Based Hospice Care Agency
- Honolulu, HI
- NPI 1811045594
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba Bristol Hospice - Inland Empire
- Community Based Hospice Care Agency
- Riverside, CA
- NPI 1043683170
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
-
dba All Saints Hospice, Inc.
- Community Based Hospice Care Agency
- Ontario, CA
- NPI 1013318112
Aware Super Pty, LTD., Bristol Hospice Holdings Inc, Bristol Hospice Topco Inc, Bristol Hospice, L.L.C., Bristol Ultimate Holdco, LP, Webster Equity Partners Bristol CF LP, Webster Equity Partners IV Bristol CF LP
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Nurse Practitioner
- Madison, WI
- NPI 1639030240
-
- Family Nurse Practitioner
- Madison, WI
- NPI 1619693959
Affiliated clinicians 14
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Family Medicine) Physician
- Oregon, WI
- NPI 1689747073
-
- Geriatric Medicine (Internal Medicine) Physician
- Madison, WI
- NPI 1790985141
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616716800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687996800000",
"number": "1992382733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 N 2100 W STE 202",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841164741",
"telephone_number": "801-325-0175",
"fax_number": "801-478-3533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "206 E OLIN AVE STE 101",
"city": "MADISON",
"state": "WI",
"postal_code": "537131434",
"telephone_number": "608-960-7699",
"fax_number": "608-716-3168"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRISTOL HOSPICE - MADISON, L.L.C.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "BRISTOL HOSPICE, L.L.C.",
"enumeration_date": "2021-03-26",
"last_updated": "2023-06-29",
"certification_date": "2023-06-29",
"status": "A",
"authorized_official_last_name": "KIRTON",
"authorized_official_first_name": "HYRUM",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT & CEO",
"authorized_official_telephone_number": "801-325-0175",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.