NPIMap

Organization Active NPI

CLHG-Ruston LLC

Doing business as Allegiance Medical Clinic

  • Family Medicine Physician
  • Ruston, LA
National Provider Identifier
1154012185
Registry record updated May 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLHG-RUSTON LLC
Doing business as
Allegiance Medical Clinic
Practice address
1200 Celebrity Dr
Ruston, LA 71270-3893
Phone
(318) 254-2100
NPI assigned
May 19, 2023
Last updated
May 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2023

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

Authorized official

Name
Kathy M Hall
Title
Ceo
Phone
(318) 254-2450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1200 Celebrity Dr
Ruston, LA 71270-3893

Mailing address

1200 Celebrity Dr
Ruston, LA 71270-3893

Other names 1

  • Allegiance Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220718002173 LA Part B Supplier - Clinic/Group Practice 7315361425 Receives reassigned benefits from 41 practitioners
4 other NPIs on this enrollment
Practice locations: Ruston, LA

Other NPIs with the same Medicare PAC ID 3

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

  • CLHG-Ruston LLC

    dba Allegiance Medical Clinic of Ruston

    • Rural Health Clinic/Center
    • Ruston, LA
    • NPI 1346904885

    7315361425

    Same PAC ID
  • CLHG-Ruston LLC

    dba Northern Louisiana Medical Center

    • Rehabilitation Hospital Unit
    • Ruston, LA
    • NPI 1770368920

    7315361425

    Same PAC ID
  • CLHG-Ruston LLC

    dba Northern Louisiana Medical Center

    • General Acute Care Hospital
    • Ruston, LA
    • NPI 1962024026

    7315361425

    Same PAC ID

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
19D2292031Allegiance Medical Clinic1200 Celebrity Drive, Ruston, LA 71270Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 41

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 41

NPI Registry JSON

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

{
    "created_epoch": "1684454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684454400000",
    "number": "1154012185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CELEBRITY DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 CELEBRITY DR",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712703893",
            "telephone_number": "318-254-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-RUSTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-19",
        "last_updated": "2023-05-19",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-254-2450"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegiance Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruston, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2023; 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.