PHC Hospice, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

PHC HOSPICE, LLC

Doing business as

Providence Hospice Care

Practice address

2831 NW 59TH St
Oklahoma City, OK 73112-7005

Phone

(405) 602-3295

NPI assigned

May 24, 2019

Organization subpart

No

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

Authorized official

Name

Brian Keith Banks

Title

Ceo/Owner

Phone

(405) 602-3295

Specialties & licenses 1

Addresses

Other names 1

• Providence Hospice Care Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Hospice certification: CCN 371734

Legal name

PHC HOSPICE, LLC

Doing business as

PROVIDENCE HOSPICE CARE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 17, 2022

Last certification

Nov 3, 2022

Organization structure

LLCProprietary

Incorporated

May 17, 2019 in OK

Enrollment address

2831 NW 59TH St
Oklahoma City, OK 73112-7005

Listed as

Providence Hospice CareCCN 371734 · All quality measures

Certified

Nov 17, 2022

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

Locations

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.

Owners & managing parties with NPI records 2

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

• Ronald Cable, DO

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1467430900

  Contracted Managing Employee

  CMS ownership
• Timothy George Ihrig, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tulsa, OK
  • NPI 1922111400

  Contracted Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Laberta Laurette Baker, RN

  • Registered Nurse
  • Norman, OK
  • NPI 1376745455
  NPD

Affiliated clinicians 3

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

• Ronald Cable, DO

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1467430900

  Hospice

  Care Compare affiliation
• Jessica Deppen, APRN

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1659774131

  Hospice

  Care Compare affiliation
• Timothy George Ihrig, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tulsa, OK
  • NPI 1922111400
  Care Compare affiliation

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

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558656000000",
    "number": "1316504392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 NW 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127005",
            "telephone_number": "405-602-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 NW 59TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731127005",
            "telephone_number": "405-602-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC HOSPICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-24",
        "last_updated": "2019-05-24",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "405-602-3295"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Hospice Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pharmacy Solutions LLC
• Pharmcareok, Inc.
• Pharmore Specialty Pharmacies LLC
• Pharos Therapy LLC
• PHC Health, LLC (Providence Home Care)
• Valerie Phelan, PTA
• Chelsea Phelps, RDN
• Haley J Phelps
• Sarah Donella Phelps, APRN, FNP-BC
• Ruby E Phifer

• Community Based Hospice Care Agency in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.