NPIMap

Organization Active NPI

CLHG-Oakdale LLC

Doing business as Oberlin Express Care

  • Rural Health Clinic/Center
  • Oberlin, LA
National Provider Identifier
1063111920
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLHG-OAKDALE LLC
Doing business as
Oberlin Express Care
Practice address
317 W. Sixth Ave
Oberlin, LA 70655
Phone
(318) 335-3700
NPI assigned
Mar 1, 2023
Last updated
Jan 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Authorized official

Name
Peter Savoy
Title
Ceo
Phone
(318) 335-3700

Specialties & licenses 1

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

Addresses

Primary practice location

317 W. Sixth Ave
Oberlin, LA 70655

Mailing address

317 Sixth Ave
Oberlin, LA 70655

Other names 1

  • Oberlin Express Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181116002285 LA Part B Supplier - Clinic/Group Practice 1355623943 Receives reassigned benefits from 71 practitioners
2 other NPIs on this enrollment
Practice locations: Oakdale, LA; Oberlin, LA
O20231027000271 LA Part A Provider - Rural Health Clinic 1355623943 Practice locations: Oberlin, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063111920. Details of each certification follow.

Rural health clinic certification: CCN 198551

Legal name
CLHG-OAKDALE LLC
Doing business as
OBERLIN EXPRESS CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 30, 2024
Last certification
Jul 30, 2024
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
317 W Sixth Ave
Oberlin, LA 70655-6406
Related CCNs
190106

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

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2283948Oberlin Express Care317 West 6TH Ave, Oberlin, LA 70655Certificate of waiverJun 13, 2027

National Provider Directory

National Provider Directory
Tax ID family
CLHG-Oakdale LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

142 Hospital Dr
Oakdale, LA 71463
Phone (318) 335-0303

1884 Highway 165 S
Oakdale, LA 71463
Phone (318) 335-3501

Ownership & related parties

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.

NameRoleSinceShare
Donald Cameron Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2016 27%
Rock Bordelon Individual 5% Or Greater Direct Ownership Interest Sep 1, 2016 65%
Kevin Ardoin Individual Corporate OfficerCeo May 26, 2023
W-2 Managing EmployeeCeo May 26, 2023
Operational/Managerial ControlCeo May 26, 2023
Scott Markstrom Individual 5% Or Greater Direct Ownership Interest Sep 1, 2016 8%
Cameron Investments LLC Organization, Shreveport, LA LLC 5% Or Greater Direct Ownership Interest Sep 1, 2016 27%

Facilities with the same owner 43

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 43

Practitioners & affiliated clinicians

Practitioners 73

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1063111920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 SIXTH AVE",
            "city": "OBERLIN",
            "state": "LA",
            "postal_code": "70655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W. SIXTH AVE",
            "city": "OBERLIN",
            "state": "LA",
            "postal_code": "70655",
            "telephone_number": "318-335-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-OAKDALE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-01",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "SAVOY",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-335-3700"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oberlin Express Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oberlin Express Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oberlin, LA

Sources for this page

Verify at the official NPI Registry.