Organization Active NPI

Godly Hospice and Palliative Care LLC

  • Community Based Hospice Care Agency
  • Longview, TX
National Provider Identifier
1780101642
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
GODLY HOSPICE AND PALLIATIVE CARE LLC
Practice address
911 W Loop 281 Ste 209
Longview, TX 75604-2908
Phone
(903) 551-3400
Fax
(430) 240-5055
NPI assigned
Aug 23, 2017
Organization subpart
Yes
Parent organization
THREE OAKS HOSPICE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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

Authorized official

Name
Andrea Bohannon
Title
President & Ceo
Phone
(214) 628-9951

Specialties & licenses 1

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

Addresses

Primary practice location

911 W Loop 281 Ste 209
Longview, TX 75604-2908

Mailing address

717 N Harwood St Ste 550
Dallas, TX 75201-6540
Phone (214) 628-9951

Other practice location 1

1303 S 1st St
Lufkin, TX 75901-4717
Phone (936) 317-3311

Other practice location 2

821 E Southeast Loop 323 Ste 140
Tyler, TX 75701-9689
Phone (903) 551-3500

Other names 5

  • THREE OAKS HOSPICE Doing business as
  • THREE OAKS HOSPICE EAST TEXAS Doing business as
  • THREE OAKS HOSPICE LONGVIEW Doing business as
  • THREE OAKS HOSPICE LUFKIN Doing business as
  • THREE OAKS HOSPICE TYLER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180315000362 TX Part A Provider - Hospice 5395007132 Practice locations: Longview, TX; Lufkin, TX; Tyler, TX

Hospice certification: CCN 741783

Legal name
GODLY HOSPICE AND PALLIATIVE CARE LLC
Doing business as
THREE OAKS HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Mar 11, 2019
Last certification
Feb 18, 2022
Ownership / control type
Proprietary - Corporation
Organization structure
LLCProprietary
Enrollment address
911 W Loop 281
Ste 209
Longview, TX 75604-2908

Care Compare: Hospice

Medicare Care Compare
Listed as
Three Oaks HospiceCCN 741783
Ownership
For-Profit
Certified
Mar 11, 2019
Medicare certification status
ActiveFrom the Provider of Services file

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
45D2145070Godly Hospice & Palliative Care, LLC911 W Loop 281, Suite 209, Longview, TX 75604Certificate of waiverFeb 28, 2028
45D2298814Godly Hospice and Palliative Care, LLC821 E Southeast Loop 323, Suite 140, Tyler, TX 75701Certificate of waiverFeb 7, 2028

National Provider Directory

National Provider Directory

Locations

2665 Villa Creek Dr
Ste 206G
Farmers Branch, TX 75234

911 W Loop 281
Ste 209
Longview, TX 75604
Phone (877) 585-7400

1303 S 1st St
Lufkin, TX 75901
Phone (936) 317-3311

821 E Southeast Loop 323
Ste 140
Tyler, TX 75701
Phone (903) 300-2977

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
David C Gasmire Individual Corporate OfficerVice President Jan 31, 2020
Corporate DirectorBoard of Directors, Member Jan 31, 2020
Cypress Purchaser, LLC Organization, Washington, DC Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 100%
Cypress Midco, Inc. Organization, Coconut Grove, FL Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 100%
Three Oaks Hospice, Inc. Organization, Dallas, TX Corporation, For-profit 5% Or Greater Direct Ownership Interest Jan 31, 2020 100%
Operational/Managerial Control Jan 31, 2020 100%
Cypress Parent Holdings, LLC Organization, Washington, DC Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 100%
Patricia Disotell Individual W-2 Managing EmployeeAd; Dec 1, 2025
Owen Davis Individual Corporate DirectorBoard of Directors, Chairman Oct 22, 2024
Other Oct 22, 2024
Kelly a Priegnitz Individual Corporate DirectorBoard of Directors, Member Oct 22, 2024
Other Oct 22, 2024
Martis Partners IV Cypress Aggregator LP Organization, Washington, DC Created for acquisition, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 80.39%
Martis Partners IV GP, LLC Organization, Washington, DC Private equity company Other Oct 22, 2024
Phillip Campbell Individual Corporate DirectorBoard of Directors, Member Oct 22, 2024
Other Oct 22, 2024
Martis Partners IV, LP Organization, Washington, DC Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 63.1%
Lisa M Pekar Individual W-2 Managing EmployeeDirector of Licensure Jan 31, 2020
Andrea F Bohannon Individual Corporate OfficerPresident, Ceo, Asst Secretary Jan 31, 2020
Corporate Director Jan 31, 2020
Ross J Taylor Individual Corporate OfficerSecretary Oct 22, 2024
Martis Partners IV PV, LP Organization, Washington, DC Private equity company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Oct 22, 2024 12.93%
Khoren Hekimian Individual Contracted Managing EmployeeMD; Oct 1, 2021

Owners & managing parties with NPI records 1

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

Facilities with the same owner 22

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 22

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1780101642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 N HARWOOD ST STE 550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752016540",
            "telephone_number": "214-628-9951",
            "fax_number": "214-389-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 W LOOP 281 STE 209",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042908",
            "telephone_number": "903-551-3400",
            "fax_number": "430-240-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1303 S 1st St",
            "address_purpose": "LOCATION",
            "city": "Lufkin",
            "state": "TX",
            "postal_code": "759014717",
            "country_code": "US",
            "telephone_number": "936-317-3311",
            "fax_number": "936-317-3322",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "821 E Southeast Loop 323 Ste 140",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757019689",
            "country_code": "US",
            "telephone_number": "903-551-3500",
            "fax_number": "903-710-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GODLY HOSPICE AND PALLIATIVE CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THREE OAKS HOSPICE INC",
        "enumeration_date": "2017-08-23",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "BOHANNON",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "214-628-9951"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THREE OAKS HOSPICE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THREE OAKS HOSPICE EAST TEXAS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THREE OAKS HOSPICE EAST TEXAS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THREE OAKS HOSPICE LONGVIEW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THREE OAKS HOSPICE LUFKIN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "THREE OAKS HOSPICE TYLER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.