NPIMap

Organization Active NPI

Harris Hospice, Inc.

  • Community Based Hospice Care Agency
  • Lewisville, TX
National Provider Identifier
1487624813
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
009245 Issued in TX
Legal business name
HARRIS HOSPICE, INC.
Practice address
550 S Edmonds LN Ste 102
Lewisville, TX 75067-3577
Phone
(972) 353-0800
Fax
(972) 353-0811
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Mr. Jay Wayne Harris, R.N.
Title
Owner
Phone
(972) 353-0800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 009245 TX Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

550 S Edmonds LN Ste 102
Lewisville, TX 75067-3577

Mailing address

550 S Edmonds LN Ste 102
Lewisville, TX 75067-3577
Phone (972) 353-0800

Other identifiers 2

IdentifierTypeStateIssuer
001019158MedicaidTX
001012754MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713000203 TX Part A Provider - Hospice 2466430756 Practice locations: Lewisville, TX

Hospice certification: CCN 451777

Legal name
HARRIS HOSPICE, INC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 1, 2004
Last certification
Feb 10, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Incorporated
Jun 11, 2004 in TX
Enrollment address
550 S Edmonds LN
Ste 102
Lewisville, TX 75067-3577

Care Compare: Hospice

Medicare Care Compare
Listed as
Harris Hospice IncCCN 451777
Ownership
For-Profit
Certified
Dec 1, 2004
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
45D1027103Harris Hospice, Inc550 S Edmonds Lane Suite 102, Lewisville, TX 75067Certificate of waiverJun 22, 2028

National Provider Directory

National Provider Directory

Locations

550 S Edmonds Ln
Ste 102
Lewisville, TX 75067
Phone (972) 956-8297

522 S Edmonds Ln
Ste 103
Lewisville, TX 75067
Phone (972) 353-0800

411 S Murphy Rd
Murphy, TX 75094
Phone (972) 665-3333

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Nancy Harris Individual 5% Or Greater Direct Ownership Interest May 10, 2010
Jay Harris Individual 5% Or Greater Direct Ownership Interest Jun 11, 2004
W-2 Managing Employee Jun 11, 2004
Marjorie Feldmann Individual 5% Or Greater Direct Ownership Interest Jun 11, 2004
Susie Pingleton Individual 5% Or Greater Direct Ownership Interest Dec 1, 2006
W-2 Managing Employee Jun 11, 2004
Jennifer Harris Individual Corporate Director Jun 1, 2009
Jay W. Harris and Nancy J. Harris Revocable Living Trust Organization, Denton, TX 5% Or Greater Direct Ownership Interest Apr 19, 2010
Paul Lambert Individual 5% Or Greater Direct Ownership Interest Jun 11, 2004

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": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1487624813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S EDMONDS LN STE 102",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673577",
            "telephone_number": "972-353-0800",
            "fax_number": "972-353-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S EDMONDS LN STE 102",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673577",
            "telephone_number": "972-353-0800",
            "fax_number": "972-353-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-353-0800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "TX",
            "license": "009245",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001019158",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001012754",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

Verify at the official NPI Registry.