Active NPI
C-Port LLC - Series B Hospice
- Community Based Hospice Care Agency
- Mansfield, TX
National Provider Identifier
1578090957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- Legal business name
- C-PORT LLC - SERIES B HOSPICE
- Practice address
- 315 S Main St
Mansfield, TX 76063-3113 - Phone
- (469) 630-2538
- NPI assigned
- May 17, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Dowd
- Title
- Member
- Phone
- (469) 630-2538
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Primary |
Addresses
Primary practice location
315 S Main St
Mansfield, TX 76063-3113
Mailing address
315 S Main St
Mansfield, TX 76063-3113
Phone (469) 630-2538
Other names 1
- AlevCare
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180110000324 | TX | Part A Provider - Hospice | 4789943168 | Practice locations: Cleburne, TX; Mansfield, TX |
Hospice certification: CCN 741754
- Legal name
- C-PORT LLC - SERIES B HOSPICE
- Doing business as
- ALEVCARE HOSPICE
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Oct 29, 2018
- Last certification
- Oct 28, 2021
- Ownership / control type
- Proprietary - Partnership
- Organization structure
- LLC
- Enrollment address
- 315 S Main St
Mansfield, TX 76063-3113
Care Compare: Hospice
Medicare Care Compare- Listed as
- Alevcare Hospice
- Ownership
- For-Profit
- Certified
- Oct 29, 2018
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2137437 | C- Port LLC Series B-Hospice | Certificate of waiver | Sep 25, 2027 |
National Provider Directory
National Provider DirectoryLocations
315 S Main St
Mansfield, TX 76063
Phone (469) 630-2538
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Elizabeth Brunson | W-2 Managing Employee | Dec 1, 2022 | |
| Craig Porter | 5% Or Greater Direct Ownership Interest | Mar 31, 2017 | 25% |
| Corporate Officer | Mar 31, 2017 | ||
| David Dowd | 5% Or Greater Direct Ownership Interest | Mar 31, 2017 | 75% |
| Corporate Officer | Mar 31, 2017 | ||
| W-2 Managing Employee | Mar 31, 2017 | ||
| Henry Dollahite | Contracted Managing Employee | Jan 1, 2023 | |
| Heather Caspersen | W-2 Managing Employee | Dec 1, 2022 | |
| Desha Hyde | Corporate Director | Apr 5, 2021 | |
| Edwin Robert Duppstadt | Contracted Managing Employee | Jan 1, 2024 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Adult Medicine Physician
- Fort Worth, TX
- NPI 1104243468
Contracted Managing Employee
-
- Family Medicine Physician
- Arlington, TX
- NPI 1982695581
Contracted Managing Employee
Practitioners & affiliated clinicians
Affiliated clinicians 9
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Geriatric Medicine (Family Medicine) Physician
- Hurst, TX
- NPI 1023209525
Hospice
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494979200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1670284800000",
"number": "1578090957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 S MAIN ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633113",
"telephone_number": "469-630-2538",
"fax_number": "469-533-3998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 S MAIN ST",
"city": "MANSFIELD",
"state": "TX",
"postal_code": "760633113",
"telephone_number": "469-630-2538"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "C-PORT LLC - SERIES B HOSPICE",
"organizational_subpart": "NO",
"enumeration_date": "2017-05-17",
"last_updated": "2022-12-06",
"certification_date": "2022-12-06",
"status": "A",
"authorized_official_last_name": "DOWD",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "469-630-2538"
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "AlevCare",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mansfield, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.