Organization Active NPI

Covenant Hospice & Palliative Care LLC

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Fort Worth, TX
National Provider Identifier
1497570980
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
COVENANT HOSPICE & PALLIATIVE CARE LLC
Practice address
2630 West Fwy Ste 130
Fort Worth, TX 76102-7117
Phone
(817) 735-8741
NPI assigned
Nov 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Russell Adkins
Title
SVP, Chief Legal Officer
Phone
(615) 926-0340

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2630 West Fwy Ste 130
Fort Worth, TX 76102-7117

Mailing address

10 Cadillac Dr Ste 400
Brentwood, TN 37027-1001
Phone (417) 841-4834

Other names 1

  • Compassus - Fort Worth Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250313004148 TX Part B Supplier - Clinic/Group Practice 2860716313 Practice locations: Fort Worth, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1497570980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 CADILLAC DR STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370271001",
            "telephone_number": "417-841-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 WEST FWY STE 130",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761027117",
            "telephone_number": "817-735-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT HOSPICE & PALLIATIVE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "ADKINS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "SVP, CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "615-926-0340"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Compassus - Fort Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.