Active NPI
Homebound Hospice Inc
- Community Based Hospice Care Agency
- Mansfield, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 006257
- Legal business name
- HOMEBOUND HOSPICE INC
- Practice address
- 2251 Country Club Dr.
Suite123
Mansfield, TX 76063-4766 - Phone
- (817) 745-9816
- Fax
- (682) 418-3446
- NPI assigned
- Nov 6, 2006
- 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
- Bradley Coleman
- Title
- Ceo
- Phone
- (502) 544-8788
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 006257 | TX | Primary |
Addresses
Primary practice location
2251 Country Club Dr.
Suite123
Mansfield, TX 76063-4766
Mailing address
2251 Country Club Dr.
Suite123
Mansfield, TX 76063-4766
Phone (817) 745-9816
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000218900 | Medicaid | TX |
Other names 1
- Cardinal 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 |
|---|---|---|---|---|
| O20060123000722 | TX | Part A Provider - Hospice | 1153345673 | Practice locations: Mansfield, TX |
Hospice certification: CCN 451687
- Legal name
- HOMEBOUND HOSPICE INC
- Doing business as
- CARDINAL HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Nov 6, 1998
- Last certification
- Sep 17, 2020
- Ownership / control type
- Proprietary - Corporation
- Organization structure
- Corporation
- Enrollment address
- 2251 Country Club Dr
Ste 123
Mansfield, TX 76063-4766
Care Compare: Hospice
Medicare Care Compare- Listed as
- Cardinal Hospice
- Ownership
- For-Profit
- Certified
- Nov 6, 1998
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryLocations
450 W Main St
Azle, TX 76020
Phone (817) 444-7992
2251 Country Club Dr
Ste 123
Mansfield, TX 76063
Phone (817) 745-9816
Ownership & related parties
All disclosed owners & managing parties 10
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 |
|---|---|---|---|
| Koryan Moye | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 15% |
| Corporate Director | Jan 28, 2025 | ||
| Abx IV Solutions LLC | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 15% |
| Jordan Coleman | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 20% |
| Corporate Officer | Jan 28, 2025 | 20% | |
| Corporate Director | Jan 28, 2025 | 20% | |
| W-2 Managing Employee | Jan 28, 2025 | ||
| Sachin S Shrestha | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 20% |
| Corporate Director | Jan 28, 2025 | 20% | |
| Sumeesh Dhawan | Contracted Managing Employee | Jan 28, 2025 | |
| Keith Fuchs | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | |
| Corporate Director | Jan 28, 2025 | 5% | |
| Cardinal Hospice Partners LLC | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 100% |
| Shalini Dhawan | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 20% |
| Corporate Director | Jan 28, 2025 | ||
| Bradley Coleman | 5% Or Greater Indirect Ownership Interest | Jan 28, 2025 | 20% |
| Corporate Officer | Jan 28, 2025 | ||
| Corporate Director | Jan 28, 2025 | ||
| W-2 Managing Employee | Jan 28, 2025 | ||
| BJSS Hospice LLC | 5% Or Greater Direct Ownership Interest | Jan 28, 2025 | 100% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Internal Medicine Physician
- Arlington, TX
- NPI 1255428827
Contracted Managing Employee
-
- Primary Care Nurse Practitioner
- Arlington, TX
- NPI 1699196469
5% Or Greater Indirect Ownership Interest, Corporate Director
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Occupational Therapy Assistant
- Weatherford, TX
- NPI 1659854966
-
- Internal Medicine Physician
- Arlington, TX
- NPI 1255428827
Affiliated clinicians 4
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1742515200000",
"number": "1417026527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 COUNTRY CLUB DR.",
"address_2": "SUITE123",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760634766",
"telephone_number": "817-745-9816",
"fax_number": "682-418-3446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2251 COUNTRY CLUB DR.",
"address_2": "SUITE123",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760634766",
"telephone_number": "817-745-9816",
"fax_number": "682-418-3446"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOMEBOUND HOSPICE INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-06",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A",
"authorized_official_last_name": "COLEMAN",
"authorized_official_first_name": "BRADLEY",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "502-544-8788"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "TX",
"license": "006257",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000218900",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cardinal Hospice",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.