Providence Hospice – Community Based Hospice Care Agency, NPI 1043214638

Providence Hospice is a healthcare provider. based in Fort worth, Texas. specializing in Community Based Hospice Care Agency. The organization holds a License No. 007477 (TX). The NPI Number for Providence Hospice is 1043214638

Main info

Organization
Name
Providence Hospice
NPI
1043214638
Phone
(817) 870-2795
Address
6100 WESTERN PLACE
Authorized Official
MS. VICTORIA JINGLE CEO
Enumeration Date
10 June 2005
Last Update Date
3 January 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness80
Years active:21State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Providence Hospice

  • 6100, Western Place, Fort Worth, Tarrant County, Texas, 76107, United States

    SUITE 105

    FORT WORTH, TX 76107

    Phone: (817) 870-2795

    Fax: (817) 878-3717

    Type: Mailing

  • 6700, Sanger Avenue, Waco, McLennan County, Texas, 76710, United States

    WACO, TX 76710

    Phone: (254) 399-9099

    Fax: (254) 399-8397

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-03-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20060308000038OHospiceTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76107)

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Reviews

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Frequently asked questions

What is Providence Hospice's NPI number?
Providence Hospice's NPI is 1043214638 — the number used across U.S. healthcare to identify this provider.
Is there an active status for Providence Hospice?
For scheduling context, Providence Hospice is shown as active in the registry.
How would a patient describe Providence Hospice's focus?
For Providence Hospice, the primary taxonomy reads as Community Based Hospice Care Agency. Clinical services aligned with this taxonomy classification.
Is Providence Hospice located near Fort Worth?
Providence Hospice currently maps to Fort Worth, Texas in this extract.
Can I trust this NPI listing for Providence Hospice?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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