Shepherd Hospice Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SHEPHERD HOSPICE INC

Doing business as

Shepherd Hospice

Practice address

14827 Ventura Blvd Ste 226
Sherman Oaks, CA 91403-5230

Phone

(747) 217-4168

Fax

(747) 207-2774

NPI assigned

Sep 8, 2020

Last updated

Sep 30, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edgardo Galang

Title

Ceo

Phone

(818) 666-1595

Specialties & licenses 1

Addresses

Other names 1

• SHEPHERD HOSPICE Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629683560. Details of each certification follow.

• CCN B31728 Hospice · Active · Details

Hospice certification: CCN B31728

Legal name

SHEPHERD HOSPICE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Feb 9, 2022

Last certification

Feb 9, 2022

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Jul 14, 2020 in CA

Enrollment address

14827 Ventura Blvd
Ste 226
Sherman Oaks, CA 91403-5230

Listed as

Shepherd Hospice IncCCN B31728 · All quality measures

Certified

Feb 9, 2022

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

All disclosed owners & managing parties 1

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

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1629683560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14827 VENTURA BLVD STE 226",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035230",
            "telephone_number": "747-217-4168",
            "fax_number": "747-207-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14827 VENTURA BLVD STE 226",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914035230",
            "telephone_number": "747-217-4168",
            "fax_number": "747-207-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHEPHERD HOSPICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "GALANG",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-666-1595"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHEPHERD HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miraf Shehata
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• Vanessa Rae Shelton
• Jessica Michelle Shenson, RD
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• Sherman Oaks Dental Arts

• Community Based Hospice Care Agency in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.

Verify at the official NPI Registry.