At Home Hospice and Palliative Care LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

AT HOME HOSPICE AND PALLIATIVE CARE LLC

Practice address

10701 Corporate Dr Ste 293
Stafford, TX 77477-4052

Phone

(832) 939-8048

Fax

(832) 939-8048

NPI assigned

Apr 4, 2020

Last updated

Apr 4, 2020By 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

Kirby Sanders, RN

Title

Owner/Administrator

Phone

(832) 939-8048

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336778042. Details of each certification follow.

• CCN 971653 Hospice · Active · Details

Hospice certification: CCN 971653

Legal name

AT HOME HOSPICE AND PALLIATIVE CARE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 17, 2021

Last certification

Jun 17, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

Not SelectedProprietary

Enrollment address

10701 Corporate Dr
Ste 293
Stafford, TX 77477-4052

Listed as

At Home Hospice and Palliative Care LLC.CCN 971653 · All quality measures

Ownership

For-Profit

Certified

Jun 17, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585958400000",
    "number": "1336778042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 293",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774052",
            "telephone_number": "832-939-8048",
            "fax_number": "832-939-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR STE 293",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774774052",
            "telephone_number": "832-939-8048",
            "fax_number": "832-939-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AT HOME HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-04",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KIRBY",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "832-939-8048",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mail",
            "affiliation": "N",
            "endpointDescription": "physical address",
            "address_1": "838 Canyon Hill Ln",
            "city": "Rosenberg",
            "state": "TX",
            "country_code": "US",
            "postal_code": "774711439",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.

Verify at the official NPI Registry.