Community Care Center of Shreveport South LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

784 Issued in LA

Legal business name

COMMUNITY CARE CENTER OF SHREVEPORT SOUTH LLC

Practice address

9712 Mansfield Rd
Shreveport, LA 71118-4406

Phone

(318) 687-2080

Fax

(318) 688-8103

NPI assigned

May 4, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Toni Parkinson

Title

Authorized Representative

Phone

(601) 709-1408

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Heritage Manor South Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Skilled nursing facility certification: CCN 195408

Legal name

COMMUNITY CARE CENTER OF SHREVEPORT SOUTH LLC

Doing business as

HERITAGE MANOR SOUTH

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Apr 1, 1997

Last certification

Oct 30, 2024

Beds

145

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Medico

Organization structure

LLCProprietary

Enrollment address

9712 Mansfield Rd
Shreveport, LA 71118-4406

Nursing home name

HERITAGE MANOR SOUTH

Affiliated entity

THE BEEBE FAMILY

Listed as

Heritage Manor SouthCCN 195408

Overall star rating

4 of 5

Health inspections

4 of 5

Staffing

3 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Apr 1, 1997

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

145108.0 residents per day on average

Chain

The Beebe Family48 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Commcare Louisiana

  • Durable Medical Equipment & Medical Supplies
  • Pineville, LA
  • NPI 1275690125

  Member Of

  NPD member

All disclosed owners & managing parties 31

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

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 55

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

• Alexandria Healthcare LLC

  • Nursing Facility/Intermediate Care Facility
  • Alexandria, LA
  • NPI 1952354086

  Account Management Services Inc, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Medico LLC, Pathway Manag

  CMS ownership
• Bossier Riverview LLC

  • Skilled Nursing Facility
  • Bossier City, LA
  • NPI 1992581961

  Act Investments, LLC, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Medico LLC, Pathway Management of Louisiana LLC, Providence Care

  CMS ownership
• Colonial Oaks Care Center of Metairie

  • Skilled Nursing Facility
  • Metairie, LA
  • NPI 1497360432

  Medico LLC, QSST TR for Alison Beebe Sadler Danos and Her Descendants, QSST TR for Felicia Beebe Stallard and Her Descendants

  CMS ownership
• Community Care Center of Baton Rouge LLC

  • Skilled Nursing Facility
  • Baton Rouge, LA
  • NPI 1871541722

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership
• Community Care Center of Covington LLC

  • Skilled Nursing Facility
  • Covington, LA
  • NPI 1942258876

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership
• Community Care Center of Destrehan LLC

  • Skilled Nursing Facility
  • Destrehan, LA
  • NPI 1770541088

  Account Management Services Inc, Administrative Systems Inc, Pathway South LLC, Provider Professional Services Inc, Tristar Rehab Inc

  CMS ownership
• Community Care Center of Hammond LLC

  • Skilled Nursing Facility
  • Hammond, LA
  • NPI 1073571212

  Account Management Services Inc, Administrative Systems Inc, Pathway South LLC, Providence Care LLC, Provider Professional Services Inc, QSST TR for Alison Beebe Sadler Danos and Her Descendants, QSST TR for Felicia Beebe Stallard and Her Descendant

  CMS ownership
• Community Care Center of Heritage House LLC

  • Skilled Nursing Facility
  • Baton Rouge, LA
  • NPI 1962469213

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership
• Community Care Center of Houma LLC

  • Skilled Nursing Facility
  • Houma, LA
  • NPI 1407804362

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership
• Community Care Center of Mandeville LLC

  • Skilled Nursing Facility
  • Mandeville, LA
  • NPI 1679531362

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Pathway South LLC, Providence Care LLC, Provider Professional Services Inc,

  CMS ownership
• Community Care Center of Opelousas LLC

  • Skilled Nursing Facility
  • Opelousas, LA
  • NPI 1821056136

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership
• Community Care Center of St Martinville LLC

  • Skilled Nursing Facility
  • Saint Martinville, LA
  • NPI 1093773301

  Account Management Services Inc, Act Investments, LLC, Administrative Systems Inc, David & Felicia Stallard Child TR, Elton Glynn Beebe Jr. & Nancy Doty Beebe Irrv TR Ua, Gerard and Alison Danos Childrens TR, Joseph & Alison Sadler Children TR, Med

  CMS ownership

Practitioners 2

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

• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820
  NPD (past)
• Allan S Matriano Lim, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1649268590
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Pat F Bass, M.D.

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1952321820

  Nursing home

  Care Compare affiliation
• Rajan Khanna, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1770581225

  Nursing home

  Care Compare affiliation
• Allan S Matriano Lim, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1649268590

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732924800000",
    "number": "1083662944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711184498",
            "telephone_number": "318-687-2080",
            "fax_number": "318-688-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9712 MANSFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711184406",
            "telephone_number": "318-687-2080",
            "fax_number": "318-688-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE CENTER OF SHREVEPORT SOUTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2024-11-30",
        "certification_date": "2024-11-30",
        "status": "A",
        "authorized_official_last_name": "PARKINSON",
        "authorized_official_first_name": "TONI",
        "authorized_official_title_or_position": "AUTHORIZED REPRESENTATIVE",
        "authorized_official_telephone_number": "601-709-1408",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521434",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31054",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Manor South",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Manor South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Shreveport, LA
• Skilled Nursing Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.