Beyondfaith Hospice of Jacksboro, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

BEYONDFAITH HOSPICE OF JACKSBORO, LLC

Doing business as

BeyondFaith Hospice of Wichita Falls, LLC

Practice address

1702 Kell Blvd
Wichita Falls, TX 76301-5627

Phone

(940) 696-8901

Fax

(940) 696-8902

NPI assigned

Mar 24, 2015

Last updated

Jun 29, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Becky Richardson, RN, BSN

Title

Owner

Phone

(940) 696-8901

Specialties & licenses 1

Addresses

Other names 1

• BeyondFaith Hospice of Wichita Falls, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225422694. Details of each certification follow.

• CCN 741656 Hospice · Active · Details

Hospice certification: CCN 741656

Legal name

BEYONDFAITH HOSPICE OF JACKSBORO LLC

Doing business as

BEYONDFAITH HOSPICE OF WICHITA FALLS LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 15, 2017

Last certification

Jan 7, 2021

Ownership / control type

Other

Organization structure

LLCProprietary

Enrollment address

1702 Kell Blvd
Wichita Falls, TX 76301-5627

Listed as

Beyondfaith Hospice of Wichita Falls LLCCCN 741656 · All quality measures

Ownership

For-Profit

Certified

Feb 15, 2017

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

All disclosed owners & managing parties 8

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

Owners & managing parties with NPI records 1

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

• Jessica Schultz, M.D.

  • Neurology Physician
  • Sugar Land, TX
  • NPI 1770561912

  Contracted Managing Employee

  CMS ownership

Facilities with the same owner 3

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

• Beyondfaith Hospice LLC

  • Community Based Hospice Care Agency
  • Graham, TX
  • NPI 1396097770

  Tracy & Becky Richardson Family LP

  CMS ownership
• Beyondfaith Hospice of Garland, LLC

  dba BeyondFaith Hospice LLC

  • Community Based Hospice Care Agency
  • Weatherford, TX
  • NPI 1518474394

  Tracy & Becky Richardson Family LP

  CMS ownership
• Beyondfaith Hospice of Lubbock LLC

  • Community Based Hospice Care Agency
  • Lubbock, TX
  • NPI 1083005938

  Tracy & Becky Richardson Family LP

  CMS ownership

Practitioners 2

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.

• Benny Wong Lam, D.P.M.

  • Foot Surgery Podiatrist
  • Wichita Falls, TX
  • NPI 1871789602
  NPD (past)
• Ashley Stewart, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Wichita Falls, TX
  • NPI 1972068682
  NPD (past)

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Christopher Mark Duhan, M.D.

  • Family Medicine Physician
  • Wichita Falls, TX
  • NPI 1265484752

  Hospice

  Care Compare affiliation
• Kevin B Lane, DO

  • Family Medicine Physician
  • Vernon, TX
  • NPI 1619979044

  Hospice

  Care Compare affiliation
• Christie Dianne Munoz, M.D.

  • Family Medicine Physician
  • Seymour, TX
  • NPI 1134515901

  Hospice

  Care Compare affiliation
• J Parkey, M.D.

  • Family Medicine Physician
  • Wichita Falls, TX
  • NPI 1912965765

  Hospice

  Care Compare affiliation
• Jessica Schultz, M.D.

  • Neurology Physician
  • Sugar Land, TX
  • NPI 1770561912

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656460800000",
    "number": "1225422694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 OAK ST STE 105",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764503070",
            "telephone_number": "940-521-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 KELL BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763015627",
            "telephone_number": "940-696-8901",
            "fax_number": "940-696-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEYONDFAITH HOSPICE OF JACKSBORO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-24",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BECKY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-696-8901",
        "authorized_official_credential": "RN, BSN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BeyondFaith Hospice of Wichita Falls, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BeyondFaith Hospice of Wichita Falls, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Blayne Berry, FNP
• Chad Michael Berry, D.C.
• Rachel S Bertleson, BACA, LBA, LPA - I
• Bestcare Health Services,Inc
• Bestcare Specialty Services, Inc.
• Pranav Purushottambhai Bhanushali
• Kalin Jeetesh Bhavan, DDS
• Terrell Bibb, M.D.
• Cameron Alexandra Bice, LPC ASSOCIATE
• Paul Lankford Bice, M.D.

• Community Based Hospice Care Agency in Wichita Falls, TX
• Providers in Wichita Falls, 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 Jun 29, 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.

Verify at the official NPI Registry.