NPIMap

Organization Active NPI

Harbor Hospice of East Texas LP

  • Community Based Hospice Care Agency
  • Jasper, TX
National Provider Identifier
1194012740
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HARBOR HOSPICE OF EAST TEXAS LP
Practice address
1440 FM 777
Jasper, TX 75951
Phone
(409) 384-3662
Fax
(409) 384-4152
NPI assigned
Jul 5, 2011
Last updated
Apr 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Authorized official

Name
Karen K Carter
Title
Exec Admin Asst
Phone
(409) 730-2046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

1440 FM 777
Jasper, TX 75951

Mailing address

PO Box 12686
Beaumont, TX 77726-2686
Phone (409) 730-2006

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120420000268 TX Part A Provider - Hospice 5890956783 Practice locations: Jasper, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194012740. Details of each certification follow.

Hospice certification: CCN 671749

Legal name
HARBOR HOSPICE OF EAST TEXAS LP
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 12, 2013
Last certification
Feb 22, 2019
Ownership / control type
Proprietary - Partnership
Organization structure
OtherProprietary
Incorporated
May 17, 2010 in TX
Enrollment address
1440 FM 777
Jasper, TX 75951

Care Compare: Hospice

Medicare Care Compare
Listed as
Harbor Hospice of East Texas LPCCN 671749 · All quality measures
Ownership
Other
Certified
Mar 12, 2013
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2035834Harbor Hospice of East Texas LP1440 FM 777, Jasper, TX 75951Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory

Locations

103 W Gibson St
Ste 150
Jasper, TX 75951
Phone (409) 384-3662

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Karen Carter Individual W-2 Managing Employee Feb 1, 2019
Bryan Gaspard Individual W-2 Managing Employee Nov 4, 2011
Arfeen Properties, L.P. Organization, Beaumont, TX 5% Or Greater Direct Ownership Interest Jun 15, 2011 99%
HHCS Managers LLC Organization, Beaumont, TX LLC General Partnership Interest Jun 15, 2011 1%
Qamar U Arfeen Individual 5% Or Greater Direct Ownership Interest Jun 15, 2011
Kelley L Arfeen Individual 5% Or Greater Direct Ownership Interest Jun 15, 2011

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 45

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 45

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 4

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": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1194012740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12686",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777262686",
            "telephone_number": "409-730-2006",
            "fax_number": "409-813-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 FM 777",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "75951",
            "telephone_number": "409-384-3662",
            "fax_number": "409-384-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR HOSPICE OF EAST TEXAS LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EXEC ADMIN ASST",
        "authorized_official_telephone_number": "409-730-2046"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

Verify at the official NPI Registry.