Living Waters Hospice, Inc.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

LIVING WATERS HOSPICE, INC.

Practice address

23315 Johnson Rd
New Caney, TX 77357-7561

Phone

(832) 723-8377

NPI assigned

Dec 19, 2012

Last updated

Oct 1, 2020By 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

Leshequa Gasper BowlesNPI 1548865587

Title

Owner

Phone

(832) 723-0420

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730425760. Details of each certification follow.

• CCN 741543 Hospice · Active · Details

Hospice certification: CCN 741543

Legal name

LIVING WATERS HOSPICE, INC.

Doing business as

LIVING WATERS HOSPICE, INC.

Certification status

Active

Provider type (POS)

Hospice

Participating since

Jun 9, 2014

Last certification

Feb 14, 2020

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 22, 2012 in TX

Enrollment address

23315 Johnson Rd
New Caney, TX 77357-7561

Listed as

Living Waters Hospice, Inc.CCN 741543 · All quality measures

Ownership

For-Profit

Certified

Jun 9, 2014

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.

Owners & managing parties with NPI records 1

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

• Leshequa Gasper Bowles

  • Family Medicine Physician
  • Porter, TX
  • NPI 1548865587

  5% Or Greater Direct Ownership Interest, 5% Or Greater Indirect Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Leshequa Gasper Bowles

  • Family Medicine Physician
  • Porter, TX
  • NPI 1548865587
  NPD Authorized official

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Christopher Scott Brann, MD

  • Hospitalist Physician
  • Houston, TX
  • NPI 1447499033

  Hospice

  Care Compare affiliation
• Robert L Duhaney, M.D.

  • Internal Medicine Physician
  • Austin, TX
  • NPI 1922151588

  Hospice

  Care Compare affiliation
• Brannon E George, M.D.

  • Internal Medicine Physician
  • Houston, TX
  • NPI 1891093662

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1730425760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23315 JOHNSON RD",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773577561",
            "telephone_number": "832-723-8377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23315 JOHNSON RD",
            "city": "NEW CANEY",
            "state": "TX",
            "postal_code": "773577561",
            "telephone_number": "832-723-8377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS HOSPICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-19",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "GASPER BOWLES",
        "authorized_official_first_name": "LESHEQUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-723-0420"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Based Hospice Care Agency in New Caney, TX
• Providers in New Caney, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.