Iph Hospice Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

IPH HOSPICE CARE INC

Practice address

190 Abner Jackson Pkwy Ste 220
Suite 220
Lake Jackson, TX 77566-5170

Phone

(979) 529-2500

Fax

(979) 529-9866

NPI assigned

Jan 20, 2006

Last updated

Sep 14, 2022By 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

Mrs. Nancy Roman

Title

Ceo

Phone

(979) 529-2500

Specialties & licenses 1

Addresses

Other identifiers 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 1417937806. Details of each certification follow.

• CCN 451784 Hospice · Active · Details

Hospice certification: CCN 451784

Legal name

IPH HOSPICE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 17, 2005

Last certification

Dec 18, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Sep 3, 2004 in TX

Enrollment address

190 Abner Jackson Parkway
Ste 220
Lake Jackson, TX 77566-5160

Listed as

Iph Hospice Care IncCCN 451784 · All quality measures

Ownership

For-Profit

Certified

Mar 17, 2005

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 4

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 1

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

• Rajesh V Dalal, MD

  • Internal Medicine Physician
  • Lake Jackson, TX
  • NPI 1316928021

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 3

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

• Bruce Alan Barker, DO

  • Family Medicine Physician
  • Bay City, TX
  • NPI 1548248461

  Hospice

  Care Compare affiliation
• Rajesh V Dalal, MD

  • Internal Medicine Physician
  • Lake Jackson, TX
  • NPI 1316928021

  Hospice

  Care Compare affiliation
• Mohammad Afzal Khan, M.D.

  • Internal Medicine Physician
  • Webster, TX
  • NPI 1417063702

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663113600000",
    "number": "1417937806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PARKWAY",
            "address_2": "SUITE 220",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-529-2500",
            "fax_number": "979-529-9866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 ABNER JACKSON PKWY STE 220",
            "address_2": "SUITE 220",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665170",
            "telephone_number": "979-529-2500",
            "fax_number": "979-529-9866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPH HOSPICE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "979-529-2500",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001013404",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holly Elizabeth Hundl, BSN, RN, FNP-C
• Yu Eun Hwang
• Infinitie Health LLC
• Intentional Actions a Behavior Analytic Approach LLC (Intentional Actions ABA)
• Iph Health Care Services, Inc. (Iph Home Health)
• Stellamaris Irabor, FNP-C
• Iso-3, L.L.C.
• Kristin Bravenec Jackson, FNP
• William Jackson Jr., O.D.
• Rakesh Jain, MD

• Community Based Hospice Care Agency in Lake Jackson, TX
• Providers in Lake Jackson, 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 Sep 14, 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.