Active NPI
Journey Hospice Care LLC
- Community Based Hospice Care Agency
- Fort Worth, TX
National Provider Identifier
1053015602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- LLC
- 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 -
- Certified
- Nov 28, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Colin Egan | 5% Or Greater Direct Ownership Interest | Mar 24, 2023 | 50% |
| Corporate Director | Mar 24, 2023 | 50% | |
| W-2 Managing Employee | Mar 24, 2023 | 50% | |
| Sara Egan | 5% Or Greater Direct Ownership Interest | Mar 24, 2023 | 50% |
| Corporate Director | Mar 24, 2023 | 50% | |
| W-2 Managing Employee | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.