Vip Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

VIP HOSPICE, LLC

Practice address

3500 North St
Suite 1B
Nacogdoches, TX 75965-2472

Phone

(936) 559-8555

Fax

(972) 248-2442

NPI assigned

May 28, 2014

Organization subpart

No

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

Authorized official

Name

Bradley P. Lassiter

Title

Ceo

Phone

(972) 248-2441

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bethany Hospice of East Texas Doing business as

Locations

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1114339975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LEGACY DR",
            "address_2": "SUITE 360",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243100",
            "telephone_number": "972-248-2441",
            "fax_number": "972-248-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NORTH ST",
            "address_2": "SUITE 1B",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652472",
            "telephone_number": "936-559-8555",
            "fax_number": "972-248-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "LASSITER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-248-2441"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3584336-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bethany Hospice of East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Xiomara Velazco-Vazquez, MD
• Gerard J Ventura, M.D.
• Hannah Marie Verhalen, M.A., LPC ASSOCIATE
• David Vinther, MD
• Randal N Vinther, M.D.
• Kavita S Vyas, M.D.
• Shyam A Vyas, MD
• Kalisha Wade, CCC SLP
• Ladedra Wade
• Wagoner Health Clinic, PLLC

• Community Based Hospice Care Agency in Nacogdoches, TX
• Providers in Nacogdoches, 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 Sep 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.