NPIMap

Organization Active NPI

Luminis Health Gilchrist Lifecare Institute, LLC

  • Community Based Hospice Care Agency
  • Annapolis, MD
National Provider Identifier
1992462667
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
LUMINIS HEALTH GILCHRIST LIFECARE INSTITUTE, LLC
Practice address
2000 Medical Pkwy Ste 607
Annapolis, MD 21401-3748
Phone
(443) 846-0355
NPI assigned
Nov 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Jennifer Modderman
Title
Revenue Cycle Manager
Phone
(443) 849-8302

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2000 Medical Pkwy Ste 607
Annapolis, MD 21401-3748

Mailing address

11311 McCormick Rd Ste 350
Hunt Valley, MD 21031-8618
Phone (443) 846-0355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220311001460 MD Part A Provider - Hospice 5991190837 Practice locations: Annapolis, MD
O20220628000085 MD Part B Supplier - Clinic/Group Practice 5991190837 Receives reassigned benefits from 19 practitioners
Practice locations: Annapolis, MD

Hospice certification: CCN 211546

Legal name
LUMINIS HEALTH GILCHRIST LIFECARE INSTITUTE, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 18, 2022
Last certification
May 18, 2022
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Aug 12, 2021 in MD
Enrollment address
2000 Medical Pkwy
Ste 607
Annapolis, MD 21401-3748

Care Compare: Hospice

Medicare Care Compare
Listed as
Luminis Health Gilchrist Life Care InstituteCCN 211546
Ownership
Other
Certified
May 18, 2022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Luminis Health Gilchrist Lifecare Institute LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

11311 McCormick Rd
Ste 350
Hunt Valley, MD 21031
Phone (443) 849-6257

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Gilchrist Hospice Care Inc Organization, Hunt Valley, MD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2022 50%
Peter Odenwald Individual Corporate DirectorDirector Jan 1, 2022
Catherine Hamel Individual Corporate OfficerChief Administrative Officer Jan 1, 2022
Elizabeth Lee Individual Corporate OfficerBoard Manager Jan 1, 2022
Corporate DirectorDirector Jan 1, 2022
Physician Enterprises LLC Organization, Annapolis, MD LLC, Non-profit 5% Or Greater Direct Ownership Interest May 18, 2022 50%
Mitchell Schwartz Individual Corporate DirectorChair Jan 1, 2022
Mark Gloth Individual Contracted Managing EmployeeChief Medical Officer Jan 1, 2023
Philip E Shaheen Individual W-2 Managing EmployeeMD; Feb 16, 2026

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

Affiliated clinicians 28

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1992462667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 MCCORMICK RD STE 350",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210318618",
            "telephone_number": "443-846-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY STE 607",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013748",
            "telephone_number": "443-846-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH GILCHRIST LIFECARE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "MODDERMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "443-849-8302"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

Verify at the official NPI Registry.