NPIMap

Organization Active NPI

Heart to Heart Hospice of the Lakes Area, LLC

  • Community Based Hospice Care Agency
  • Jasper, TX
National Provider Identifier
1780143933
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
HEART TO HEART HOSPICE OF THE LAKES AREA, LLC
Practice address
2014 S Wheeler St Ste 250
Jasper, TX 75951-5628
Phone
(409) 384-5700
Fax
(409) 384-5177
NPI assigned
Mar 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Authorized official

Name
Kelly Mitchell
Title
Manager
Phone
(972) 517-6300

Specialties & licenses 1

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

Addresses

Primary practice location

2014 S Wheeler St Ste 250
Jasper, TX 75951-5628

Mailing address

7240 Chase Oaks Blvd
Plano, TX 75025-5901
Phone (972) 517-6300

Other names 1

  • Olive Branch Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190715000220 TX Part A Provider - Hospice 5890020812 Practice locations: Jasper, TX; Livingston, TX; Huntsville, TX; Hemphill, TX
O20231215000960 TX Part B Supplier - Clinic/Group Practice 5890020812 Receives reassigned benefits from 1 practitioner
Practice locations: Jasper, TX

Hospice certification: CCN 971522

Legal name
HEART TO HEART HOSPICE OF THE LAKES AREA, LLC
Doing business as
OLIVE BRANCH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 10, 2019
Last certification
Jul 21, 2022
Ownership / control type
Proprietary - Partnership
Organization structure
LLCProprietary
Incorporated
Feb 5, 2019 in TX
Enrollment address
2014 S Wheeler St
Ste 250
Jasper, TX 75951-5628

Care Compare: Hospice

Medicare Care Compare
Listed as
Olive Branch HospiceCCN 971522
Ownership
For-Profit
Certified
Oct 10, 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
45D2195288Heart to Heart Hospice of the Lakes Area2014 S Wheeler, Suite 250, Jasper, TX 75951Certificate of waiverOct 6, 2026

National Provider Directory

National Provider Directory

Locations

1217 15th St
Ste 2
Huntsville, TX 77340

2051 S Wheeler St
Ste E
Jasper, TX 75951
Phone (409) 383-0788

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Bridget N Hearn Individual 5% Or Greater Direct Ownership InterestManaging Employee Dec 2, 2021 1.75%
Other Jan 2, 2023 1.75%
Crystal Heigley Individual 5% Or Greater Direct Ownership InterestManaging Employee Dec 2, 2021 1%
Other Dec 2, 2021 1%
Gregory L Gray Individual 5% Or Greater Direct Ownership InterestOwnership Interest Dec 2, 2021 10.25%
Flower Moon Holdings, LLC Organization, Plano, TX Created for acquisition, LLC 5% Or Greater Direct Ownership Interest Nov 30, 2021 75%
Tiffany Coggins Individual W-2 Managing EmployeeAd; Jul 17, 2023
Richard R Riggins Individual Contracted Managing EmployeeMD; Jan 14, 2021
Teresa Brown Individual 5% Or Greater Direct Ownership InterestOwnership Interest Dec 2, 2021 10.25%
Molly Siau Individual 5% Or Greater Direct Ownership InterestManaging Employee Dec 2, 2021 1.75%
OtherOwnership Interest Jan 2, 2023 1.75%
Erica a Errigo Individual W-2 Managing EmployeeAd; Jan 1, 2025
Kelly Mitchell Individual Corporate OfficerManager Dec 2, 2021
W-2 Managing EmployeeManager Dec 2, 2021

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1780143933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 CHASE OAKS BLVD",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750255901",
            "telephone_number": "972-517-6300",
            "fax_number": "972-517-6310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 S WHEELER ST STE 250",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515628",
            "telephone_number": "409-384-5700",
            "fax_number": "409-384-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART TO HEART HOSPICE OF THE LAKES AREA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-517-6300"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olive Branch Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jasper, TX

Sources for this page

Verify at the official NPI Registry.