Interdisciplinary Hospice Providers LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

INTERDISCIPLINARY HOSPICE PROVIDERS LLC

Practice address

1102 Tanglewood Dr
Mansfield, TX 76063-2802

Phone

(214) 435-1683

NPI assigned

Jul 2, 2021

Organization subpart

No

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

Authorized official

Name

Tracy King

Title

Alter Administrator

Phone

(214) 912-0807

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625184000000",
    "number": "1902477706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 TANGLEWOOD DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632802",
            "telephone_number": "214-435-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 TANGLEWOOD DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632802",
            "telephone_number": "214-435-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERDISCIPLINARY HOSPICE PROVIDERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-02",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "ALTER ADMINISTRATOR",
        "authorized_official_telephone_number": "214-912-0807"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.