Active NPI
Blue Horizon Hospice of Texas LLC
- Community Based Hospice Care Agency
- Plano, TX
National Provider Identifier
1164149191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- BLUE HORIZON HOSPICE OF TEXAS LLC
- Practice address
- 6600 Chase Oaks Blvd Ste 1007
Plano, TX 75023-2381 - Phone
- (214) 584-7077
- NPI assigned
- Oct 20, 2022
- 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
- Suja Kurian
- Title
- Administrator
- Phone
- (214) 584-7077
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
6600 Chase Oaks Blvd Ste 1007
Plano, TX 75023-2381
Mailing address
6600 Chase Oaks Blvd Ste 1007
Plano, TX 75023-2381
Phone (214) 584-7077
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230922002284 | TX | Part A Provider - Hospice | 4486008570 | Practice locations: Plano, TX |
Hospice certification: CCN A91731
- Legal name
- BLUE HORIZON HOSPICE OF TEXAS LLC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 26, 2024
- Last certification
- Aug 6, 2024
- Organization structure
- LLC
- Incorporated
- Oct 18, 2022 in TX
- Enrollment address
- 6600 Chase Oaks Blvd
Ste 1007
Plano, TX 75023-2381
Care Compare: Hospice
Medicare Care Compare- Listed as
- Blue Horizon Hospice of Texas LLC
- Certified
- Aug 26, 2024
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
6600 Chase Oaks Blvd
Ste 1007
Plano, TX 75023
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 |
|---|---|---|---|
| Sasha Job | 5% Or Greater Direct Ownership Interest | Oct 18, 2022 | 50% |
| Corporate Officer | Oct 18, 2022 | ||
| W-2 Managing Employee | Oct 18, 2022 | ||
| Kimberlyn Lucken | 5% Or Greater Direct Ownership Interest | Oct 18, 2022 | 50% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666224000000",
"number": "1164149191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 CHASE OAKS BLVD STE 1007",
"city": "PLANO",
"state": "TX",
"postal_code": "750232381",
"telephone_number": "214-584-7077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 CHASE OAKS BLVD STE 1007",
"city": "PLANO",
"state": "TX",
"postal_code": "750232381",
"telephone_number": "214-584-7077"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUE HORIZON HOSPICE OF TEXAS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-10-20",
"last_updated": "2022-10-20",
"certification_date": "2022-10-20",
"status": "A",
"authorized_official_last_name": "KURIAN",
"authorized_official_first_name": "SUJA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "214-584-7077"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plano, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.