Mid State Orthopaedic & Sports Medicine Center, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC

Practice address

3444 Masonic Drive
Alexandria, LA 71301

Phone

(318) 473-9556

Fax

(318) 441-8339

NPI assigned

Feb 16, 2006

Last updated

Mar 24, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nakita C Hickman

Title

Credentialing Manager

Phone

(318) 441-8329

Specialties & licenses 4

Addresses

Other names 1

• Mid-State Orthopaedic & Sports Medicine Center Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in LA2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Mid State Orthopaedic & Sports Medicine Center LLC

  • Orthopaedic Surgery Physician
  • Ville Platte, LA
  • NPI 1447707583
  NPPES parent name
• Mid State Orthopaedic & Sports Medicine Center LLC

  • Orthopaedic Surgery Physician
  • Jena, LA
  • NPI 1609320506
  NPPES parent name

Practitioners 56

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.

• Mark A Carbo, PA-C

  • Physician Assistant
  • Alexandria, LA
  • NPI 1508889312
  Medicare reassignment Care Compare group NPD
• Larry Justin Doughty, M.D.

  • Pain Medicine Physician
  • Alexandria, LA
  • NPI 1922549211

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Abby Lou Fennell, O.T.

  • Occupational Therapist
  • Pineville, LA
  • NPI 1740887694
  Medicare reassignment Care Compare group NPD
• Mandy Guilliams, FNP-C

  • Family Nurse Practitioner
  • Alexandria, LA
  • NPI 1578291258
  Medicare reassignment Care Compare group NPD
• Tiffany Nicole Hayes, PA-C

  • Physician Assistant
  • Alexandria, LA
  • NPI 1538137906

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• George H Lacour, OTR, CHT

  • Hand Occupational Therapist
  • Alexandria, LA
  • NPI 1477599645
  Medicare reassignment Care Compare group NPD
• Janssen Shawn Meeker, DPT

  • Physical Therapist
  • Alexandria, LA
  • NPI 1417409996
  Medicare reassignment Care Compare group NPD
• Daniel R Oas, D.O.

  • Orthopaedic Surgery Physician
  • Alexandria, LA
  • NPI 1093782443
  Medicare reassignment Care Compare group NPD
• Miles Stanley Parsons, M.D.

  • Orthopaedic Surgery Physician
  • Alexandria, LA
  • NPI 1407385586
  Medicare reassignment Care Compare group NPD
• Tori Anne Peery, PT, DPT

  • Physical Therapist
  • Pineville, LA
  • NPI 1508611534
  Medicare reassignment Care Compare group NPD
• Stephen Robert Price, PA-C

  • Physician Assistant
  • Alexandria, LA
  • NPI 1609840438
  Medicare reassignment Care Compare group NPD
• Rebecca Lynne Smilie, P.T.

  • Physical Therapist
  • Alexandria, LA
  • NPI 1669775805
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1104890052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3444 MASONIC DRIVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3444 MASONIC DRIVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71301",
            "telephone_number": "318-473-9556",
            "fax_number": "318-441-8339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "429 Rocky Bayou Dr",
            "address_purpose": "LOCATION",
            "city": "Pineville",
            "state": "LA",
            "postal_code": "713608133",
            "country_code": "US",
            "telephone_number": "318-441-8329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "HICKMAN",
        "authorized_official_first_name": "NAKITA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "318-441-8329"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-State Orthopaedic & Sports Medicine Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Mid-State Orthopaedic & Sports Medicine Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Matthew J Meynard, CRNA
• Michael Dole MD, a Professional Medical Corp.
• Jeremy James Michot, LOTR
• Megan Mickel
• Mid Louisiana Surgical Specialists
• Mid State Orthopaedic Urgent Care, LLC
• Mid State Orthopaedics & Sports Medicine Center LLC
• Mid State Surgical Center, LLC
• Mid- State Home Health Agency Inc
• Mid-Louisiana Anesthesia Consultants, Apmc

• Orthopaedic Surgery Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Orthopaedic Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.