Organization Active NPI

Passion 05 Health Services, Inc

  • Home Health Agency
  • Dallas, TX
National Provider Identifier
1588840599
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PASSION 05 HEALTH SERVICES, INC
Practice address
1140 Empire Central Dr Ste 630
Dallas, TX 75247-4393
Phone
(214) 253-2654
Fax
(214) 253-2655
NPI assigned
Jan 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Authorized official

Name
Alero Tina Okundia, RN
Title
Administrator
Phone
(214) 253-2654

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X TX Primary

Addresses

Primary practice location

1140 Empire Central Dr Ste 630
Dallas, TX 75247-4393

Mailing address

1140 Empire Central Dr Ste 630
Dallas, TX 75247-4393
Phone (214) 253-2654

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060320000038 TX Part A Provider - Home Health Agency 2062429871 Practice locations: Dallas, TX

Home health agency certification: CCN 679708

Legal name
PASSION 05 HEALTH SERVICES, INC
Doing business as
PASSION 05 HEALTH SERVICES, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 7, 2007
Last certification
Feb 21, 2020
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 30, 2005 in TX
Enrollment address
1317 Empire Central Dr
Dallas, TX 75247-4021

Care Compare: Home health agency

Medicare Care Compare
Listed as
Passion 05 Health Services IncCCN 679708
Ownership
Proprietary
Certified
Nov 7, 2007
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
45D1050627Passion 05 Health Services, Inc1140 Empire Central Dr Suite 630, Dallas, TX 75247Certificate of waiverFeb 6, 2028

National Provider Directory

National Provider Directory

Locations

8500 N Stemmons Fwy
Ste 4025
Dallas, TX 75247
Phone (214) 253-2654

1317 Empire Central Dr
Dallas, TX 75247
Phone (214) 253-2654

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Alero Okundia Individual 5% Or Greater Direct Ownership InterestOwner Sep 30, 2005 100%
Corporate OfficerBoard Member Oct 1, 2005 100%
Corporate DirectorOwner Oct 1, 2005 100%
W-2 Managing EmployeeAdministrator/Don/Supervising Nu Oct 1, 2005 100%
Operational/Managerial ControlManaging Employees Oct 1, 2005 100%
Sam Okundia Individual W-2 Managing EmployeeAlternate Administrator Feb 6, 2006
Operational/Managerial Control Feb 1, 2006
Patricia Ikechukwu Individual Corporate Director Apr 9, 2007
W-2 Managing EmployeeAdon/Supervising Nurse Apr 9, 2007
Operational/Managerial ControlAlternate Don Apr 9, 2007

NPI Registry JSON

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649116800000",
    "number": "1588840599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 EMPIRE CENTRAL DR STE 630",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474393",
            "telephone_number": "214-253-2654",
            "fax_number": "214-253-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 EMPIRE CENTRAL DR STE 630",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474393",
            "telephone_number": "214-253-2654",
            "fax_number": "214-253-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSION 05 HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A",
        "authorized_official_last_name": "OKUNDIA",
        "authorized_official_first_name": "ALERO",
        "authorized_official_middle_name": "TINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-253-2654",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.