Three Rivers Consulting & Management ,LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

37-1692 Issued in OK

Legal business name

THREE RIVERS CONSULTING & MANAGEMENT ,LLC

Doing business as

Complete Hospice Care of Eastern Oklahoma

Practice address

621 S Park Dr
Broken Bow, OK 74728-5331

Phone

(805) 501-0850

Fax

(580) 501-0853

NPI assigned

Oct 23, 2007

Last updated

Jan 24, 2025By 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

Lola Jane Edwards, RN

Title

Administrator

Phone

(805) 584-6608

Specialties & licenses 1

Addresses

Other names 1

• Complete Hospice Care of Eastern Oklahoma Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881883148. Details of each certification follow.

• CCN 371692 Hospice · Active · Details

Hospice certification: CCN 371692

Legal name

THREE RIVERS CONSULTING & MANAGEMENT ,LLC

Doing business as

COMPLETE HOSPICE CARE OF EASTERN OKLAHOMA

Certification status

Active

Provider type (POS)

Hospice

Participating since

Mar 4, 2010

Last certification

Mar 30, 2021

Ownership / control type

Proprietary - Individual

Organization structure

CorporationProprietary

Incorporated

Oct 1, 2018 in OK

Enrollment address

621 S Park Dr
Broken Bow, OK 74728-5331

Listed as

Complete Hospice Care of Eastern OklahomaCCN 371692 · All quality measures

Ownership

For-Profit

Certified

Mar 4, 2010

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 5

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 3

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

• Sean D Boone, D.O.

  • Family Medicine Physician
  • Hugo, OK
  • NPI 1629019237

  Contracted Managing Employee

  CMS ownership
• Michael Curtis West Jr., MD

  • Family Medicine Physician
  • Idabel, OK
  • NPI 1649346545

  Contracted Managing Employee

  CMS ownership
• Satish Ramesh Bagdure, M.D.

  • Internal Medicine Physician
  • Allen, TX
  • NPI 1316264971

  Contracted Managing Employee

  CMS ownership

Affiliated clinicians 5

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

• Sean D Boone, D.O.

  • Family Medicine Physician
  • Hugo, OK
  • NPI 1629019237

  Hospice

  Care Compare affiliation
• James M Ross, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tulsa, OK
  • NPI 1285605113
  Care Compare affiliation
• Michael Curtis West Jr., MD

  • Family Medicine Physician
  • Idabel, OK
  • NPI 1649346545

  Hospice

  Care Compare affiliation
• Farshid A Zandi, M.D

  • Hospitalist Physician
  • Muskogee, OK
  • NPI 1578510657

  Hospice

  Care Compare affiliation
• Satish Ramesh Bagdure, M.D.

  • Internal Medicine Physician
  • Allen, TX
  • NPI 1316264971

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1193097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1881883148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285331",
            "telephone_number": "580-351-6577",
            "fax_number": "580-501-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285331",
            "telephone_number": "805-501-0850",
            "fax_number": "580-501-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS CONSULTING & MANAGEMENT ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-23",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "LOLA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-584-6608",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "OK",
            "license": "37-1692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Complete Hospice Care of Eastern Oklahoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stover Family Clinic
• Rebecca Stover, RN, NP-C
• Pierre Francis Taron III, D.C.
• Texarkana Eye Associates-Broken Bow Branch
• Tobe Thacker, D.C.
• TLC Family Clinic, LLC
• Tobe Thacker (Broken Bow Chiropractic)
• Sarah Todd
• Renisa Underwood
• Catherine Valencia, LPC

• Community Based Hospice Care Agency in Broken Bow, OK
• Providers in Broken Bow, OK by specialty
• Community Based Hospice Care Agency in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.