Organization Active NPI

Yellow Rose Hospice Care, Inc.

  • Community Based Hospice Care Agency
  • San Antonio, TX
National Provider Identifier
1467000489
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
YELLOW ROSE HOSPICE CARE, INC.
Practice address
2819 NW Loop 410 Ste F
San Antonio, TX 78230-5105
Phone
(210) 797-7316
NPI assigned
Sep 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Kimberley Winn
Title
Owner
Phone
(210) 797-7316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

2819 NW Loop 410 Ste F
San Antonio, TX 78230-5105

Mailing address

2819 NW Loop 410 Ste F
San Antonio, TX 78230-5105
Phone (210) 797-7316

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201023002936 TX Part A Provider - Hospice 5395165781 Practice locations: San Antonio, TX

Hospice certification: CCN 971659

Legal name
YELLOW ROSE HOSPICE CARE INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Apr 26, 2021
Last certification
Apr 26, 2021
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Aug 13, 2019 in TX
Enrollment address
2819 NW Loop 410
Ste F
San Antonio, TX 78230

Care Compare: Hospice

Medicare Care Compare
Listed as
Yellow Rose Hospice Care, Inc.CCN 971659
Ownership
For-Profit
Certified
Apr 26, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2177708Yellow Rose Hospice Care, Inc2819 NW Loop 410 Suite F, San Antonio, TX 78230Certificate of waiverJan 15, 2028

National Provider Directory

National Provider Directory

Locations

2819 NW Loop 410
Ste F
San Antonio, TX 78230
Phone (210) 797-7316

Ownership & related parties

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.

NameRoleSinceShare
Kimberley Winn Individual 5% Or Greater Direct Ownership InterestCfo Apr 14, 2021 50%
Corporate Officer Apr 14, 2021
Corporate Director Apr 14, 2021
W-2 Managing Employee Apr 14, 2021
Rosa Sumega Individual 5% Or Greater Direct Ownership InterestCoo Apr 14, 2021 50%
Corporate Officer Apr 14, 2021
Corporate Director Apr 14, 2021
W-2 Managing Employee Apr 14, 2021

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

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": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1467000489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 NW LOOP 410 STE F",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305105",
            "telephone_number": "210-797-7316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 NW LOOP 410 STE F",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305105",
            "telephone_number": "210-797-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLOW ROSE HOSPICE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-797-7316"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.