Organization Active NPI

Proteam Hospice LLC

  • Community Based Hospice Care Agency
  • Dallas, TX
National Provider Identifier
1629806740
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
PROTEAM HOSPICE LLC
Practice address
10935 Estate LN Ste 190
Dallas, TX 75238-2371
Phone
(214) 272-8824
NPI assigned
Jul 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Authorized official

Name
Corine Ngaha
Title
Administrator
Phone
(972) 688-6374

Specialties & licenses 1

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

Addresses

Primary practice location

10935 Estate LN Ste 190
Dallas, TX 75238-2371

Mailing address

10935 Estate LN Ste 190
Dallas, TX 75238-2371
Phone (972) 688-6374

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250226003368 TX Part A Provider - Hospice 7113447624 Practice locations: Dallas, TX

Hospice certification: CCN E21504

Legal name
PROTEAM HOSPICE LLC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Dec 11, 2025
Last certification
Nov 26, 2025
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Incorporated
Jul 18, 2024 in TX
Enrollment address
10935 Estate LN
Ste 190
Dallas, TX 75238-2371

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Corine Ngaha Individual 5% Or Greater Direct Ownership InterestAdministrator Jul 18, 2024 100%
W-2 Managing EmployeeAd; Jul 18, 2024 100%
Shliea K Tabbytite Individual W-2 Managing EmployeeAd; Oct 14, 2024 50%
Jessica Eben Individual W-2 Managing EmployeeAd; Oct 14, 2024 50%
Sumana Ketha Individual Contracted Managing EmployeeMD; Oct 14, 2024 50%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1629806740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10935 ESTATE LN STE 190",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382371",
            "telephone_number": "972-688-6374",
            "fax_number": "972-688-6032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10935 ESTATE LN STE 190",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752382371",
            "telephone_number": "214-272-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTEAM HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "NGAHA",
        "authorized_official_first_name": "CORINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-688-6374"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.