Active NPI
Rolling Meadows Hospice, LLC
- Community Based Hospice Care Agency
- Bedford, TX
National Provider Identifier
1295074466
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- ROLLING MEADOWS HOSPICE, LLC
- Practice address
- 1600 Airport Fwy Ste 503
Bedford, TX 76022-6882 - Phone
- (972) 402-9300
- Fax
- (972) 402-9303
- NPI assigned
- Feb 7, 2013
- 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
- Kyle Smith
- Title
- Chief Executive Officer
- Phone
- (972) 402-9300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
1600 Airport Fwy Ste 503
Bedford, TX 76022-6882
Mailing address
1600 Airport Fwy Ste 503
Bedford, TX 76022-6882
Phone (972) 402-9300
Other names 1
- Holy Savior Hospice
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130607000434 | TX | Part A Provider - Hospice | 3971741612 | Practice locations: Bedford, TX |
Hospice certification: CCN 671780
- Legal name
- ROLLING MEADOWS HOSPICE LLC
- Doing business as
- HOLY SAVIOR HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 29, 2013
- Last certification
- Aug 15, 2019
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- LLC
- Incorporated
- Jan 25, 2013 in TX
- Enrollment address
- 1600 Airport Freeway
Suite 503
Bedford, TX 76022-6850
Care Compare: Hospice
Medicare Care Compare- Listed as
- Holy Savior Hospice
- Ownership
- For-Profit
- Certified
- Aug 29, 2013
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Holy Savior Hospice
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community Based Hospice Care Agency
- Dallas, TX
- NPI 1932515830
Locations
8500 N Stemmons Fwy
Ste 200
Dallas, TX 75247
10340 Alta Vista Rd
Fort Worth, TX 76244
Phone (682) 551-4333
Ownership & related parties
All disclosed owners & managing parties 1
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 |
|---|---|---|---|
| Kyle M Smith | 5% Or Greater Direct Ownership Interest | Apr 18, 2014 | 100% |
| Corporate Officer | Apr 18, 2014 | 100% | |
| Operational/Managerial Control | Apr 18, 2014 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 10
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Physical Medicine & Rehabilitation Physician
- San Antonio, TX
- NPI 1700955176
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360195200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599696000000",
"number": "1295074466",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 AIRPORT FWY STE 503",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226882",
"telephone_number": "972-402-9300",
"fax_number": "972-402-9303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 AIRPORT FWY STE 503",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226882",
"telephone_number": "972-402-9300",
"fax_number": "972-402-9303"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROLLING MEADOWS HOSPICE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-07",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "KYLE",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "972-402-9300"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Holy Savior Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Bedford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; 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.