NPIMap

CLHG-Oakdale LLC

Organization Active NPI Rural Health Clinic/Center · Oberlin, LA

NPI 1063111920 · NPPES record last updated Jan 27, 2025

Key facts

NPI
1063111920
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CLHG-OAKDALE LLC
Practice address
317 W. Sixth Ave
Oberlin, LA 70655
Phone
(318) 335-3700
NPI assigned
Mar 1, 2023
Organization subpart
No

Authorized official

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

Other NPIs on the same Medicare enrollment 2

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

Other NPIs with the same Medicare PAC ID 5

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

Corporate family (same tax ID) 7

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

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

Facilities with the same owner 43

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

View all 43

Practitioners 74

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 74

Laboratory certificates & supplier records

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

CLIA laboratory certificates

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

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
LLC · Proprietary
Enrollment address
317 W Sixth Ave
Oberlin, LA 70655-6406
Related CCNs
190106

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 Officer
Ceo		 May 26, 2023
W-2 Managing Employee
Ceo		 May 26, 2023
Operational/Managerial Control
Ceo		 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%

Medicare enrollment records

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

National Provider Directory

Tax ID family
CLHG-Oakdale LLC (8 organizations share this tax ID)

Locations

301 4th St
Ste 3H
Alexandria, LA 71301
Phone (318) 441-1030

1420 Blankenship Dr
Deridder, LA 70634
Phone (337) 460-9472

4855 Highway 10
Ste C
Elizabeth, LA 70638
Phone (318) 634-5600

Specialties & licenses

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

Addresses

Primary practice location

317 W. Sixth Ave
Oberlin, LA 70655

Mailing address

317 Sixth Ave
Oberlin, LA 70655

Other names

  • Oberlin Express Care Doing business as

Other providers in Oberlin, LA

All providers in Oberlin, LA · Rural Health Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.