North Caddo Hospital Service District

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTH CADDO HOSPITAL SERVICE DISTRICT

Practice address

815 S Pine St
Vivian, LA 71082-3353

Phone

(318) 375-4007

NPI assigned

Mar 19, 2018

Organization subpart

Yes

Parent organization

NORTH CADDO HOSPITAL SERVICE DISTRICTAs reported in NPPES

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

Authorized official

Name

Mr. Dakota Robinson

Title

Cfo

Phone

(318) 375-4097

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• NCMC Medical and Surgical Clinic Doing business as

Tax ID family

N Caddo Medical Center5 organizations share this tax ID, including this one

Part of

N Caddo Medical Center

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• North Caddo Hospital Service District

  • Critical Access Hospital
  • Vivian, LA
  • NPI 1417124959
  NPD tax ID
• North Caddo Hospital Service District

  • Ambulance
  • Vivian, LA
  • NPI 1649671579
  NPD tax ID
• North Caddo Hospital Service District

  • Critical Access Hospital
  • Vivian, LA
  • NPI 1962679407
  NPD tax ID
• North Caddo Medical Center Healthplex

  • Public Health or Welfare Agency
  • Vivian, LA
  • NPI 1124155411
  NPD tax ID

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652400000000",
    "number": "1003310756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S PINE ST",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710823353",
            "telephone_number": "318-375-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S PINE ST",
            "city": "VIVIAN",
            "state": "LA",
            "postal_code": "710823353",
            "telephone_number": "318-375-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CADDO HOSPITAL SERVICE DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH CADDO HOSPITAL SERVICE DISTRICT",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "DAKOTA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-375-4097",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1038130",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCMC Medical and Surgical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauretta Montgomery
• Nexion Health at Vivian, Inc.
• Christian Nguyen
• North Caddo Anesthesia Billing
• North Caddo Drug
• North Caddo Hospital Service District
• North Caddo Hospital Service District
• North Caddo Hospital Service District
• North Caddo Hospital Service District
• North Caddo Hospital Service District

• All providers in Vivian, LA
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.