Full Care Hospice and Palliative Care Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

FULL CARE HOSPICE AND PALLIATIVE CARE INC

Practice address

509 Marin St Ste 221
Thousand Oaks, CA 91360-4230

Phone

(805) 371-6190

NPI assigned

Oct 28, 2020

Last updated

Aug 22, 2023By 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

Connie Roush

Title

Owner

Phone

(805) 371-6190

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831799824. Details of each certification follow.

• CCN B41529 Hospice · Active · Details

Hospice certification: CCN B41529

Legal name

FULL CARE HOSPICE AND PALLIATIVE CARE INC

Certification status

Active

Provider type (POS)

Hospice

Participating since

Oct 23, 2021

Last certification

Oct 23, 2021

Ownership / control type

Proprietary - Corporation

Organization structure

CorporationProprietary

Incorporated

Oct 27, 2020 in CA

Enrollment address

509 Marin St
Ste 221
Thousand Oaks, CA 91360-4230

Listed as

Full Care Hospice and Palliative Care Inc.CCN B41529 · All quality measures

Certified

Oct 23, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

Affiliated clinicians 1

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

• Karen L Fields, MD

  • Internal Medicine Physician
  • Camarillo, CA
  • NPI 1497779656

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1831799824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MARIN ST STE 221",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604230",
            "telephone_number": "805-371-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MARIN ST STE 221",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913604230",
            "telephone_number": "805-371-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL CARE HOSPICE AND PALLIATIVE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-28",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-371-6190"
    },
    "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 Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Community Based Hospice Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.