Organization Active NPI

Journey Hospice Care LLC

  • Community Based Hospice Care Agency
  • Fort Worth, TX
National Provider Identifier
1053015602
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
JOURNEY HOSPICE CARE LLC
Practice address
3309 Winthrop Ave Ste 88
Fort Worth, TX 76116-5600
Phone
(682) 553-1163
NPI assigned
Mar 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Authorized official

Name
Sara Egan
Title
Ambr
Phone
(682) 553-1163

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

3309 Winthrop Ave Ste 88
Fort Worth, TX 76116-5600

Mailing address

3309 Winthrop Ave Ste 88
Fort Worth, TX 76116-5600
Phone (682) 553-1163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719001956 TX Part A Provider - Hospice 0941660195 Practice locations: Fort Worth, TX

Hospice certification: CCN A91688

Legal name
JOURNEY HOSPICE CARE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 28, 2023
Last certification
Nov 15, 2023
Organization structure
LLCProprietary
Incorporated
Mar 24, 2023 in TX
Enrollment address
3309 Winthrop Ave
Ste 88
Fort Worth, TX 76116-5600

Care Compare: Hospice

Medicare Care Compare
Listed as
Journey Hospice Care LLC -CCN A91688
Certified
Nov 28, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

3309 Winthrop Ave
Ste 88
Fort Worth, TX 76116
Phone (682) 553-1163

Ownership & related parties

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.

NameRoleSinceShare
Colin Egan Individual 5% Or Greater Direct Ownership InterestPresident/Treasurer Mar 24, 2023 50%
Corporate DirectorPresident/Treasurer Mar 24, 2023 50%
W-2 Managing EmployeePresident/Treasurer Mar 24, 2023 50%
Sara Egan Individual 5% Or Greater Direct Ownership InterestVice President/Secretary/Admin/Don Mar 24, 2023 50%
Corporate DirectorVice President/Secretary/Admin/Don Mar 24, 2023 50%
W-2 Managing EmployeeVice President/Secretary/Admin/Don Mar 24, 2023 50%

Practitioners & affiliated clinicians

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688515200000",
    "number": "1053015602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 WINTHROP AVE STE 88",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165600",
            "telephone_number": "682-553-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3309 WINTHROP AVE STE 88",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165600",
            "telephone_number": "682-553-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY HOSPICE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A",
        "authorized_official_last_name": "EGAN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "682-553-1163"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.