NPIMap

Organization Active NPI

Good Shepherd Hospice of Dallas, L.L.C.

  • Community Based Hospice Care Agency
  • Dallas, TX
National Provider Identifier
1205939816
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
009630 Issued in TX
Legal business name
GOOD SHEPHERD HOSPICE OF DALLAS, L.L.C.
Practice address
7920 Belt Line Rd Ste 760
Dallas, TX 75254-8188
Phone
(972) 870-9991
Fax
(972) 870-9993
NPI assigned
Sep 7, 2006
Last updated
Oct 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Mr. Jason Kyle Delester
Title
Manager
Phone
(405) 943-0903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 009630 TX Primary

Addresses

Primary practice location

7920 Belt Line Rd Ste 760
Dallas, TX 75254-8188

Mailing address

7920 Belt Line Rd Ste 760
Dallas, TX 75254-8188
Phone (972) 870-9991

Other identifiers 1

IdentifierTypeStateIssuer
001013322MedicaidTX

Other names 1

  • Compassionate Hands Hospice Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/SDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050124000774 TX Part A Provider - Hospice 0648220038 Practice locations: Dallas, TX; Ft Worth, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205939816. Details of each certification follow.

Hospice certification: CCN 451799

Legal name
GOOD SHEPHERD HOSPICE OF DALLAS, LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 8, 2005
Last certification
Apr 16, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Aug 27, 2004 in OK
Enrollment address
7920 Belt Line Rd
Ste 760
Dallas, TX 75254-8188

Care Compare: Hospice

Medicare Care Compare
Listed as
Good Shepherd Hospice of Dallas LLCCCN 451799 · All quality measures
Ownership
For-Profit
Certified
Jul 8, 2005
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

7920 Belt Line Rd
Ste 760
Dallas, TX 75254
Phone (972) 870-9991

1212 E Lancaster Ave
Fort Worth, TX 76102
Phone (682) 300-1272

100 E 15th St
Ste 650
Ft Worth, TX 76102
Phone (682) 300-1272

9150 N Royal Ln
Ste 160
Irving, TX 75063
Phone (972) 870-9991

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Jason Kyle Delester Individual Corporate OfficerManager, LLC/Authorized Official Sep 30, 2005
Shellie K Greiner Individual 5% Or Greater Indirect Ownership InterestTrustee Aug 27, 2004 100%
Jerianne Ranieri Individual W-2 Managing EmployeeAd; Apr 1, 2025 100%
Syed M a Jamal Individual Contracted Managing EmployeeMD; May 1, 2024 100%
Shellie K Greiner Revocable Trust Organization, Edmond, OK 5% Or Greater Direct Ownership Interest Aug 27, 2004 100%

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 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 1

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": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1205939816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 BELT LINE RD STE 760",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548188",
            "telephone_number": "972-870-9991",
            "fax_number": "972-870-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 BELT LINE RD STE 760",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548188",
            "telephone_number": "972-870-9991",
            "fax_number": "972-870-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD HOSPICE OF DALLAS, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "DELESTER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "405-943-0903",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "009630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013322",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/SDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd SteB",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Compassionate Hands Hospice",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.