Southern Legacy Hospice LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

SOUTHERN LEGACY HOSPICE LLC

Practice address

33300 Egypt LN Ste L800
Magnolia, TX 77354-3322

Phone

(213) 550-7205

NPI assigned

Aug 17, 2022

Organization subpart

No

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

Authorized official

Name

Mr. Sajid H Siddiqui, DO

Title

Adm

Phone

(213) 550-7205

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Hospice certification: CCN A91658

Legal name

SOUTHERN LEGACY HOSPICE LLC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 24, 2023

Last certification

Nov 2, 2023

Organization structure

LLCProprietary

Incorporated

Jun 9, 2022 in TX

Enrollment address

33300 Egypt LN
L800
Magnolia, TX 77354-3322

Listed as

Southern Legacy Hospice LLCCCN A91658

Certified

Nov 24, 2023

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 2

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.

• Nadeem Jamil

  • Geriatric Medicine (Internal Medicine) Physician
  • The Woodlands, TX
  • NPI 1649234576

  5% Or Greater Direct Ownership Interest, Corporate Director, W-2 Managing Employee

  CMS ownership

Affiliated clinicians 1

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

• Nadeem Jamil

  • Geriatric Medicine (Internal Medicine) Physician
  • The Woodlands, TX
  • NPI 1649234576

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1760100697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33300 EGYPT LN STE L800",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773543322",
            "telephone_number": "213-550-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33300 EGYPT LN STE L800",
            "city": "MAGNOLIA",
            "state": "TX",
            "postal_code": "773543322",
            "telephone_number": "213-550-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN LEGACY HOSPICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "SIDDIQUI",
        "authorized_official_first_name": "SAJID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADM",
        "authorized_official_telephone_number": "213-550-7205",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Sontheimer, PT
• Hasaan Sorathia, DMD
• Ernest E Sorenson, DPM
• Ariadna Soto
• Soul Care Counseling Magnolia PLLC
• Southern Wellness Chiropractic PLLC
• Sarah Spann
• Speech Magnolias, PLLC
• Alexis Squires, PT
• Gary Lee Squyres, DDS

• Community Based Hospice Care Agency in Magnolia, TX
• Providers in Magnolia, 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 Jan 5, 2026; 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.