Advance Care Plus Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

ADVANCE CARE PLUS HOSPICE LLC

Practice address

18319 Licola Meadow LN
Richmond, TX 77407-3607

Phone

(832) 788-7707

NPI assigned

Dec 1, 2023

Organization subpart

No

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

Authorized official

Name

Rachael Ebegboni, RN

Title

Ceo

Phone

(832) 788-7707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN A91714

Legal name

ADVANCE CARE PLUS HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 24, 2024

Last certification

Mar 15, 2024

Organization structure

LLCProprietary

Incorporated

Dec 1, 2023 in UT

Enrollment address

18319 Licola Meadow LN
Richmond, TX 77407-3607

Listed as

Advance Care Plus Hospice LLCCCN A91714

Certified

Mar 24, 2024

Medicare certification status

ActiveFrom the Provider of Services file

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.

Owners & managing parties with NPI records 1

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

• Hameed Q Ali, D. O.

  • Internal Medicine Physician
  • Temple, TX
  • NPI 1104974955

  Contracted Managing Employee

  CMS ownership

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1003682824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18319 LICOLA MEADOW LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774073607",
            "telephone_number": "832-788-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18319 LICOLA MEADOW LN",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774073607",
            "telephone_number": "832-788-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CARE PLUS HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "EBEGBONI",
        "authorized_official_first_name": "RACHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "832-788-7707",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.