FMC - Deep East Texas LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

010406 Issued in TX

Legal business name

FMC - DEEP EAST TEXAS LLC

Practice address

317 W Church St
Suite 112
Livingston, TX 77351-3201

Phone

(936) 327-9991

Fax

(936) 327-9995

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Rich Fogle

Title

Cfo

Phone

(904) 493-6748

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Embracing Hospice Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Hospice Partners of America Holding, LLC.

  • Community Based Hospice Care Agency
  • Waco, TX
  • NPI 1568818599

  Sold to, 2016-05-11

  CMS change of ownership

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1083662852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 N LAURA ST STE 1800",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322023614",
            "telephone_number": "904-493-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W CHURCH ST",
            "address_2": "SUITE 112",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773513201",
            "telephone_number": "936-327-9991",
            "fax_number": "936-327-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FMC - DEEP EAST TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "FOGLE",
        "authorized_official_first_name": "RICH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "904-493-6748"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "010406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "010406",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014561",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embracing Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey E Fine, DMD
• Meghan Cecelia Finley, ATC
• Trace Adam Flores
• Flynn Counseling PLLC
• Sheila Lanay Flynn, M.ED, NCC, LPC
• Crystal Dawn Fonville, LMFT
• Karen Fowler-Arias, MS OTR/L
• Myrel Camitoc Francisco, P.T.
• Frank S, Walker,Jr.,M.D.,P.a.
• Frank S. Walker, Jr. ,M.D., P.a.

• Community Based Hospice Care Agency in Livingston, TX
• Providers in Livingston, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.