Active NPI
Hospice of South Texas, Inc
- Community Based Hospice Care Agency
- Victoria, TX
National Provider Identifier
1881697274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Based Hospice Care Agency
- License
- 001930
- Legal business name
- HOSPICE OF SOUTH TEXAS, INC
- Practice address
- 605 E Locust Ave
Victoria, TX 77901-3933 - Phone
- (361) 572-4300
- Fax
- (361) 572-8109
- NPI assigned
- May 31, 2005
- Last updated
- Jan 3, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Anne McIntosh
- Title
- Chief Financial Officer
- Phone
- (361) 572-4300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | 001930 | TX | Primary |
Addresses
Primary practice location
605 E Locust Ave
Victoria, TX 77901-3933
Mailing address
605 E Locust Ave
Victoria, TX 77901-3933
Phone (361) 572-4300
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HH6922 | Other | TX | BLUE CROSS BLUE SHIELD |
| 002016000 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 2
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1881697274. Details of each certification follow.
Hospice certification: CCN 451525
- Legal name
- HOSPICE OF SOUTH TEXAS, INC
- Certification status
- Active
- Provider type (POS)
- Hospice
- Participating since
- Aug 10, 1988
- Last certification
- Oct 2, 2020
- Ownership / control type
- Non-Profit - Other
- Organization structure
- Corporation
- Enrollment address
- 605 E Locust Avenue
Victoria, TX 77901-3933
Care Compare: Hospice
Medicare Care Compare- Listed as
- Hospice of South Texas Inc
- Ownership
- Non-Profit
- Certified
- Aug 10, 1988
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Hospice of South Texas Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Palliative Care Center of South Texas
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Victoria, TX
- NPI 1336451046
Locations
1111 Summit Ave
Fl 4
Fort Worth, TX 76102
213 E 2nd St
Hallettsville, TX 77964
Phone (361) 572-4300
1005 Mallette Dr
Victoria, TX 77904
Phone 3617035375211
Ownership & related parties
All disclosed owners & managing parties 25
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Tyson K Meyer | Contracted Managing Employee | Sep 4, 2019 | 25% |
| Corporate Director | Sep 4, 2019 | 5% | |
| Susan Rodriguez | Corporate Director | Jan 1, 2025 | 5% |
| Walker Lee Keeling | Corporate Officer | Jan 1, 2024 | 5.26% |
| Charles Wartsbaugh | Corporate Director | Jan 18, 2018 | 5% |
| Jennifer Nichols | W-2 Managing Employee | Mar 31, 2025 | |
| Michael Chavez | Corporate Officer | Mar 14, 2022 | 5% |
| W-2 Managing Employee | Mar 14, 2022 | 50% | |
| Christopher Krejci | Corporate Officer | Jan 1, 2021 | 5% |
| Hospice of South Texas, Inc | Operational/Managerial Control | Apr 10, 1985 | 100% |
| Anne McIntosh | Corporate Director | Aug 10, 2005 | |
| William H McArdle | Corporate Director | Jan 24, 2019 | 5% |
| Daniel a Cano | Corporate Director | Jan 1, 2022 | 5% |
| David Smolik | Corporate Director | Jan 18, 2018 | 5% |
| Matt Bochat | Corporate Director | Jan 1, 2024 | 5.26% |
| Stacey Hall | Corporate Director | Jan 1, 2025 | 5% |
| Laurence Bludau | Corporate Director | Jan 1, 2025 | 5% |
| Laurie Eder | W-2 Managing Employee | Mar 17, 2025 | 100% |
| Herbert Beyer | Corporate Officer | Jan 1, 2021 | 5% |
| Susan Oakley | Corporate Officer | Jan 1, 2014 | 5% |
| Elena Watts | Corporate Director | Jan 18, 2018 | 5% |
| Judy Hill | Corporate Director | Jan 1, 2022 | 5% |
| Gerald Bludau | Corporate Director | Jan 24, 2019 | 5% |
| James F Neumann | Corporate Director | Jan 1, 2025 | 5% |
| Rose M Drost | Corporate Director | Jan 24, 2019 | 5% |
| Timothy Michalski | Corporate Director | Jan 23, 2019 | 5% |
| Lynn Miori | Corporate Officer | Jan 1, 2021 | 5% |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Victoria, TX
- NPI 1508040361
Contracted Managing Employee, Corporate Director
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Victoria, TX
- NPI 1508040361
-
- Internal Medicine Physician
- Victoria, TX
- NPI 1235246752
Affiliated clinicians 17
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": "1117497600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578009600000",
"number": "1881697274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 E LOCUST AVE",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779013933",
"telephone_number": "361-572-4300",
"fax_number": "361-572-8109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 E LOCUST AVE",
"city": "VICTORIA",
"state": "TX",
"postal_code": "779013933",
"telephone_number": "361-572-4300",
"fax_number": "361-572-8109"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOSPICE OF SOUTH TEXAS, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-31",
"last_updated": "2020-01-03",
"certification_date": "2020-01-03",
"status": "A",
"authorized_official_last_name": "MCINTOSH",
"authorized_official_first_name": "ANNE",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "361-572-4300",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "251G00000X",
"taxonomy_group": "",
"desc": "Hospice Care, Community Based",
"state": "TX",
"license": "001930",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "HH6922",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002016000",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
- Caia Dawn Homerstad Williams, O.D.
- Hometown Pediatric Care, PA
- Hong T. Dang, O.D., P.a. (Access Eye Care)
- Hop Medical Services, M.D.P.a.
- Hospice of South Texas, Inc (Palliative Care Center of South Texas)
- Kaci Hotz
- Marva Jeanne Hougen, RN
- Joel William Houghton, FNP-BC
- Joyce Howard, FNP
- Michael Wayne Howie, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.