NPIMap

Organization Active NPI

Hospice Brazos Valley, Inc.

  • Community Based Hospice Care Agency
  • Bryan, TX
National Provider Identifier
1245232149
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2186 Issued in TX
Legal business name
HOSPICE BRAZOS VALLEY, INC.
Practice address
502 W 26TH St
Bryan, TX 77803-2426
Phone
(979) 821-2266
Fax
(979) 821-2763
NPI assigned
Aug 11, 2005
Last updated
Dec 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Authorized official

Name
Mrs. Lisa McNair
Title
President/Ceo
Phone
(979) 821-2266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2186 TX Primary

Addresses

Primary practice location

502 W 26TH St
Bryan, TX 77803-2426

Mailing address

502 W 26TH St
Bryan, TX 77803-2426
Phone (979) 821-2266

Other practice location 1

302 E Blue Bell Rd
Brenham, TX 77833-2406
Phone (979) 277-9525

Other practice location 2

1048 N Jefferson St
LA Grange, TX 78945-1210
Phone (979) 968-6913

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060727000196 TX Part A Provider - Hospice 9234142829 Practice locations: Bryan, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245232149. Details of each certification follow.

Hospice certification: CCN 451547

Legal name
HOSPICE BRAZOS VALLEY INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 10, 1991
Last certification
Oct 22, 2021
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Nov 23, 1981 in TX
Enrollment address
502 W 26TH Street
Bryan, TX 77803-2426

Care Compare: Hospice

Medicare Care Compare
Listed as
Hospice Brazos Valley IncCCN 451547 · All quality measures
Ownership
For-Profit
Certified
Apr 10, 1991
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

302 E Blue Bell Rd
Brenham, TX 77833
Phone (979) 277-9525

1048 N Jefferson St
La Grange, TX 78945
Phone (979) 968-6913

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.

NameRoleSinceShare
Thomas Owen Borgstedte Individual Contracted Managing EmployeeMD; Aug 1, 2007
Lisa McNair Individual Corporate Director Jan 1, 2022
W-2 Managing EmployeeAd; Jan 1, 2022

Owners & managing parties with NPI records 1

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

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1245232149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 W 26TH ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778032426",
            "telephone_number": "979-821-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 W 26TH ST",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778032426",
            "telephone_number": "979-821-2266",
            "fax_number": "979-821-2763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 E Blue Bell Rd",
            "address_purpose": "LOCATION",
            "city": "Brenham",
            "state": "TX",
            "postal_code": "778332406",
            "country_code": "US",
            "telephone_number": "979-277-9525",
            "fax_number": "979-277-9575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1048 N Jefferson St",
            "address_purpose": "LOCATION",
            "city": "LA Grange",
            "state": "TX",
            "postal_code": "789451210",
            "country_code": "US",
            "telephone_number": "979-968-6913",
            "fax_number": "979-968-6943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HOSPICE BRAZOS VALLEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "MCNAIR",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "979-821-2266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "2186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.