NPIMap

Organization Active NPI

Fairmont Hospice LLC

Doing business as Fairmont Hospice

  • Community Based Hospice Care Agency
  • Richmond, TX
National Provider Identifier
1437597150
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
FAIRMONT HOSPICE LLC
Doing business as
Fairmont Hospice
Practice address
300 Jackson St
Richmond, TX 77469-3109
Phone
(888) 846-7742
Fax
(888) 251-8801
NPI assigned
Jun 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Authorized official

Name
Mrs. Nidhu Kurup, R.N.
Title
Administrator
Phone
(832) 434-2670

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary
In Home Supportive Care Agency 253Z00000X TX

Addresses

Primary practice location

300 Jackson St
Richmond, TX 77469-3109

Mailing address

300 Jackson St
Richmond, TX 77469-3109
Phone (888) 846-7742

Other names 1

  • Fairmont Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160831002973 TX Part A Provider - Hospice 5991091894 Practice locations: Richmond, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437597150. Details of each certification follow.

Hospice certification: CCN 741576

Legal name
FAIRMONT HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jul 26, 2015
Last certification
Oct 21, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Mar 22, 2016 in TX
Enrollment address
300 Jackson St
Richmond, TX 77469-3109

Care Compare: Hospice

Medicare Care Compare
Listed as
Fairmont HospiceCCN 741576 · All quality measures
Ownership
For-Profit
Certified
Jul 26, 2015
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

300 Jackson St
Richmond, TX 77469
Phone (726) 246-0161

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Kudige Realty Inc Organization, Missouri City, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 29, 2016 20%
King Pass Enterprises Inc Organization, Sugar Land, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 29, 2016 20%
Fairmont Hospice LLC Organization, Richmond, TX LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 29, 2016 100%
Oniel Kurup Individual Corporate OfficerCeo Apr 29, 2016
Operational/Managerial Control Dec 31, 2013
Vijay Korimilli Individual Contracted Managing EmployeeMD; Jul 28, 2021 100%
Lindsey Haigood Individual W-2 Managing EmployeeAd; Feb 6, 2026
Operational/Managerial ControlInterim Hospice Administrator Feb 6, 2026
Saracom Holdings LP Organization, Sugar Land, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 29, 2016 20%
Family Health Consultants P a. Organization, Houston, TX Corporation, For-profit 5% Or Greater Indirect Ownership Interest Apr 29, 2016 20%
Hospice Care of USA LLC Organization, Sugar Land, TX Created for acquisition, LLC, For-profit 5% Or Greater Indirect Ownership Interest Apr 29, 2016 20%

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Affiliated clinicians 10

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": "1370390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597363200000",
    "number": "1437597150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 JACKSON ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693109",
            "telephone_number": "888-846-7742",
            "fax_number": "888-251-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 JACKSON ST",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693109",
            "telephone_number": "888-846-7742",
            "fax_number": "888-251-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMONT HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-05",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A",
        "authorized_official_last_name": "KURUP",
        "authorized_official_first_name": "NIDHU",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "832-434-2670",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairmont Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fairmont Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.