NPIMap

Organization Active NPI

Freedom Hospice, LLC

  • Community Based Hospice Care Agency
  • North Richland Hills, TX
National Provider Identifier
1063452373
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
014560 Issued in TX
Legal business name
FREEDOM HOSPICE, LLC
Practice address
9001 Airport Fwy
Suite 570
North Richland Hills, TX 76180-7769
Phone
(817) 265-0151
Fax
(817) 265-0145
NPI assigned
Jun 7, 2006
Last updated
Oct 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Tyler C McKibben
Title
Cfo/Vice President
Phone
(817) 265-0151

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 009809 TX
Community Based Hospice Care Agency 251G00000X 012778 TX
Community Based Hospice Care Agency 251G00000X 014560 TX Primary

Addresses

Primary practice location

9001 Airport Fwy
Suite 570
North Richland Hills, TX 76180-7769

Mailing address

9001 Airport Fwy
Suite 570
North Richland Hills, TX 76180-7769
Phone (817) 265-0151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050601000886 TX Part A Provider - Hospice 5799727665 Practice locations: N Richland Hills, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063452373. Details of each certification follow.

Hospice certification: CCN 671527

Legal name
FREEDOM HOSPICE, LLC
Doing business as
FREEDOM HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 19, 2006
Last certification
Jun 1, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Feb 4, 2005 in TX
Enrollment address
9001 Airport Fwy
Ste 570
N Richland Hills, TX 76180-7774

Care Compare: Hospice

Medicare Care Compare
Listed as
Freedom HospiceCCN 671527 · All quality measures
Ownership
For-Profit
Certified
May 19, 2006
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1907 Ascension Blvd
Ste 200
Arlington, TX 76006
Phone (817) 265-0151

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Jay Dempsey Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2012 0.49%
Jim Andrew Individual 5% Or Greater Indirect Ownership InterestChief Executive Officer Sep 1, 2012 16.77%
Corporate OfficerChief Executive Officer Sep 1, 2012 16.77%
Corporate DirectorChief Executive Officer Sep 1, 2012 16.77%
W-2 Managing Employee Sep 1, 2011
Sterling Holdings, LLC Organization, North Richland Hills, TX Created for acquisition, LLC General Partnership Interest Aug 27, 2011
Operational/Managerial Control Aug 27, 2011 100%
Tyler McKibben Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2012 16.73%
Corporate OfficerCfo Sep 1, 2012 16.73%
Richard Nemeroff Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2012 5%
Sterling Hospice Partners, LP Organization, North Richland Hills, TX Created for acquisition, For-profit 5% Or Greater Direct Ownership Interest Sep 1, 2012 49%
David Key Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2012 0.49%
Sterling Holdings LLC Organization, North Richland Hills, TX Created for acquisition, LLC 5% Or Greater Indirect Ownership Interest Sep 1, 2012 33.5%
Sterling Genpar, LP Organization, North Richland Hills, TX Created for acquisition General Partnership Interest Aug 27, 2011 100%

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1063452373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 AIRPORT FWY",
            "address_2": "SUITE 570",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807769",
            "telephone_number": "817-265-0151",
            "fax_number": "817-265-0145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 AIRPORT FWY",
            "address_2": "SUITE 570",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761807769",
            "telephone_number": "817-265-0151",
            "fax_number": "817-265-0145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEDOM HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "MCKIBBEN",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO/VICE PRESIDENT",
        "authorized_official_telephone_number": "817-265-0151"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "009809",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "012778",
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "014560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Richland Hills, TX

Sources for this page

Verify at the official NPI Registry.