NPIMap

Organization Active NPI

Homer Memorial Hospital

Doing business as Butler-Abshire Medical Clinic

  • Rural Health Clinic/Center
  • Haynesville, LA
National Provider Identifier
1003409335
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOMER MEMORIAL HOSPITAL
Doing business as
Butler-Abshire Medical Clinic
Practice address
926 Frances Dr
Haynesville, LA 71038-6100
Phone
(318) 624-0554
NPI assigned
Feb 17, 2021
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HOMER MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Anna Lee Jones, RN
Title
Chief Quality and Integration Offic
Phone
(318) 927-2024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

926 Frances Dr
Haynesville, LA 71038-6100

Mailing address

620 E College St
Homer, LA 71040-3202
Phone (318) 927-2024

Other names 1

  • Butler-Abshire Medical Clinic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.claibornemedical.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210413000461 LA Part A Provider - Rural Health Clinic 1456322692 Practice locations: Haynesville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003409335. Details of each certification follow.

Rural health clinic certification: CCN 198508

Legal name
HOMER MEMORIAL HOSPITAL
Doing business as
BUTLER-ABSHIRE MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 1, 2018
Last certification
Mar 29, 2025
Ownership / control type
Non-profit – church related
Most recent change of ownership
Mar 29, 2022 (1 total)
Organization structure
OtherNon-profit
Incorporated
Jan 1, 1949 in LA
Enrollment address
926 Frances Dr
Haynesville, LA 71038-6100
Related CCNs
190114

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Homer Memorial Hospital13 organizations share this tax ID, including this one
Part of
Homer Memorial Hospital

Other organizations with this tax ID 12

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

Locations

926 Frances Dr
Haynesville, LA 71038
Phone (318) 624-0554

620 E College St
Homer, LA 71040
Phone (318) 927-2024

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Anna Lee Jones Individual W-2 Managing Employee Jan 1, 2021
Tina Haynes Individual Corporate OfficerCeo Dec 1, 2019

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Homer Medical ClinicHomer, LA, CCN 198507 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 30, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Change-of-ownership history 1

DateEventCounterparty
Mar 29, 2021 Change of OwnershipThis provider was the buyer Butler-Abshire Medical ClinicCCN 198508, LA, NPI 1518464775

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1003409335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E COLLEGE ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403202",
            "telephone_number": "318-927-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 FRANCES DR",
            "city": "HAYNESVILLE",
            "state": "LA",
            "postal_code": "710386100",
            "telephone_number": "318-624-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMER MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOMER MEMORIAL HOSPITAL",
        "enumeration_date": "2021-02-17",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF QUALITY AND INTEGRATION OFFIC",
        "authorized_official_telephone_number": "318-927-2024",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.claibornemedical.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "926 Frances Dr",
            "city": "Haynesville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710386100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Butler-Abshire Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haynesville, LA

Sources for this page

Verify at the official NPI Registry.