Kelton Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

018670 Issued in TX

Legal business name

KELTON HOSPICE, INC.

Practice address

5070 Kinsey Dr
Tyler, TX 75703-3005

Phone

(903) 218-6870

Fax

(903) 218-6874

NPI assigned

May 10, 2012

Organization subpart

No

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

Authorized official

Name

Blake R Rich

Title

Owner/Operator

Phone

(903) 792-0716

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Hospice of East Texas Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN 671761

Legal name

KELTON HOSPICE, INC.

Doing business as

HERITAGE HOSPICE OF EAST TEXAS

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 14, 2013

Last certification

May 26, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jan 1, 2012 in TX

Enrollment address

5070 Kinsey Dr
Tyler, TX 75703-3005

Listed as

Heritage Hospice of East TexasCCN 671761

Ownership

For-Profit

Certified

Jun 14, 2013

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 2

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

Affiliated clinicians 5

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

• Christian Ferrer, MD

  • Family Medicine Physician
  • Quitman, TX
  • NPI 1376077164

  Hospice

  Care Compare affiliation
• Khoren Hekimian, DO

  • Family Medicine Physician
  • Troup, TX
  • NPI 1588695423

  Hospice

  Care Compare affiliation
• Sahil Parikh, DO

  • Internal Medicine Physician
  • Tyler, TX
  • NPI 1346864154

  Hospice

  Care Compare affiliation
• Thomas C Selvaggi, M.D.

  • Family Medicine Physician
  • Commerce, TX
  • NPI 1255326393

  Hospice

  Care Compare affiliation
• Jonathan Lewis Henderson, MD

  • Critical Care Medicine (Internal Medicine) Physician
  • Cincinnati, OH
  • NPI 1497910459

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643068800000",
    "number": "1346509494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 TEXAS BLVD",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755033028",
            "telephone_number": "903-792-0716",
            "fax_number": "903-792-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5070 KINSEY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033005",
            "telephone_number": "903-218-6870",
            "fax_number": "903-218-6874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Technology Ctr",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756052756",
            "country_code": "US",
            "telephone_number": "903-218-6870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KELTON HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "903-792-0716"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "018670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001027951",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Hospice of East Texas",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Kelly
• Laura Kelly
• Suzanne S Kelly
• Leslie Kelso
• Donna Keltner
• Melissa Lynn Kemp, PA-C, DHSC
• Susan Kemp
• Vivian S Kemp, L.P.C.
• Kendall DDS PLLC
• Kimberly Kendrick

• Community Based Hospice Care Agency in Tyler, TX
• Providers in Tyler, 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 Jan 25, 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.