NPIMap

Organization Active NPI

Ochsner American Legion Hospital LLC

  • Rural Health Clinic/Center
  • Lake Arthur, LA
National Provider Identifier
1104576289
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
OCHSNER AMERICAN LEGION HOSPITAL LLC
Practice address
328 Kellogg Ave
Lake Arthur, LA 70549-4116
Phone
(337) 774-0100
Fax
(337) 744-0111
NPI assigned
Mar 24, 2022
Organization subpart
Yes
Parent organization
OCHSNER AMERICAN LEGION HOSPITAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Dana Williams
Title
Ceo
Phone
(337) 616-7000

Specialties & licenses 1

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

Addresses

Primary practice location

328 Kellogg Ave
Lake Arthur, LA 70549-4116

Mailing address

1634 Elton Rd
Jennings, LA 70546-3614

Other names 1

  • Ochsner Health Center - Lake Arthur Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220531000549 LA Part B Supplier - Hospital Department(S) 4688051717 Receives reassigned benefits from 47 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eunice, LA; Jennings, LA; Lake Arthur, LA; Welsh, LA
O20220602000336 LA Part A Provider - Rural Health Clinic 4688051717 Practice locations: Lake Arthur, LA

Rural health clinic certification: CCN 193496

Legal name
OCHSNER AMERICAN LEGION HOSPITAL, LLC
Doing business as
OCHSNER HEALTH CENTER - LAKE ARTHUR
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 21, 2016
Last certification
Dec 21, 2025
Ownership / control type
2B
Organization structure
LLCProprietary
Incorporated
Dec 21, 2021 in LA
Enrollment address
328 Kellogg Avenue
Lake Arthur, LA 70549-4116
Related CCNs
190053

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 4

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
19D0990543Ochsner Health Center-Lake Arthur328 Kellogg Street, Lake Arthur, LA 70549Provider-performed microscopyAug 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ochsner American Legion Hospital LLC9 organizations share this tax ID, including this one
Part of
Ochsner American Legion Hospital LLC

Other organizations with this tax ID 8

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

Member of 1

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

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Michael F Hulefeld Individual Corporate OfficerPresident & Chief Operating Officer Apr 1, 2022
Lafayette General Health System Inc Organization, Lafayette, LA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2022 100%
Operational/Managerial Control Apr 1, 2022
Peter C November Individual Corporate OfficerChief Executive Officer Apr 1, 2022
Roger Mattke Individual Corporate OfficerChief Financial Officer Apr 1, 2022
Other Apr 1, 2022
Dana D Williams Individual Corporate OfficerChief Executive Officer Apr 1, 2022
W-2 Managing EmployeeChief Executive Officer Apr 1, 2022
Operational/Managerial ControlChief Executive Officer Apr 1, 2022
Patrick Gandy Individual Corporate DirectorMember of Governing Board Apr 1, 2022
Operational/Managerial ControlCeo of Lafayette General Health Apr 1, 2022
James M Molloy Individual Corporate OfficerEvp - Cfo & Treasurer Jan 1, 2024
Ochsner Clinic Foundation Organization, New Orleans, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 1, 2022 100%
Operational/Managerial Control Apr 1, 2022
Al Patin Individual Corporate DirectorMember of Governing Board Apr 1, 2022
Operational/Managerial Control Apr 1, 2022

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Ochsner Health Center - JenningsJennings, LA, CCN 193495 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2022

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 74

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

View all 74

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1104576289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 KELLOGG AVE",
            "city": "LAKE ARTHUR",
            "state": "LA",
            "postal_code": "705494116",
            "telephone_number": "337-774-0100",
            "fax_number": "337-744-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCHSNER AMERICAN LEGION HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OCHSNER AMERICAN LEGION HOSPITAL LLC",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-616-7000"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ochsner Health Center - Lake Arthur",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ochsner Health Center - Lake Arthur",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Arthur, LA

Sources for this page

Verify at the official NPI Registry.