Organization Active NPI

Carson Investments of Louisiana, Inc

  • Community Based Hospice Care Agency
  • Shreveport, LA
National Provider Identifier
1194034868
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
CARSON INVESTMENTS OF LOUISIANA, INC
Practice address
4427 Youree Dr
Shreveport, LA 71105-3620
Phone
(318) 402-3555
Fax
(318) 861-2587
NPI assigned
Sep 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Mr. Scott Ryan Carson
Title
Ceo
Phone
(318) 402-3555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X LA Primary

Addresses

Primary practice location

4427 Youree Dr
Shreveport, LA 71105-3620

Mailing address

1404 Magnolia RDG
Bossier City, LA 71112-5042
Phone (318) 402-3555

Other names 1

  • Nightingale Hospice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111007000619 LA Part A Provider - Hospice 9335311687 Practice locations: Bossier City, LA

Hospice certification: CCN 191686

Legal name
CARSON INVESTMENTS OF LOUISIANA, INC
Doing business as
NIGHTINGALE HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 19, 2013
Last certification
May 23, 2019
Ownership / control type
Proprietary - Corporation
Organization structure
CorporationProprietary
Enrollment address
4530 Barkdale Blvd
Suite a & A2
Bossier City, LA 71112-4598

Care Compare: Hospice

Medicare Care Compare
Listed as
Nightingale HospiceCCN 191686
Ownership
For-Profit
Certified
Jun 19, 2013
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

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
Reuven Alter Individual 5% Or Greater Indirect Ownership InterestPom Health, LLC Member Jan 21, 2022 6%
Stephen Wediger Individual 5% Or Greater Indirect Ownership InterestPom Health, LLC Member Jan 21, 2022 6%
Mark Tress Individual 5% Or Greater Indirect Ownership InterestPom Health, LLC Member Jan 21, 2022 6%
Yaakov Septimus Individual 5% Or Greater Indirect Ownership InterestPom Health, LLC Member Jan 21, 2022 6%
Brian a Monaco Individual Contracted Managing EmployeeMD; Nov 7, 2022
Chaim Rottenberg Individual 5% Or Greater Indirect Ownership InterestPom Health, LLC Member Jan 21, 2022 6%
Scott Carson Individual 5% Or Greater Indirect Ownership InterestAuthorized Official/Owner Jan 21, 2022 51%
Corporate OfficerPresident Jun 18, 2010
Operational/Managerial Control Jun 18, 2010
Lisa Carson Individual 5% Or Greater Indirect Ownership InterestAuthorized Official/Administrator Jan 21, 2022 19%
Corporate Officer Jun 18, 2010
Corporate Director Jun 18, 2010
W-2 Managing EmployeeAd; Jun 18, 2010
Operational/Managerial ControlAdministrator Jun 18, 2010
Carson Investments of Louisiana, Inc Organization, Bossier City, LA Corporation, LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 18, 2010 100%
5% Or Greater Indirect Ownership Interest Jan 21, 2022 100%
Operational/Managerial Control Jun 18, 2010 100%

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 1

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

Affiliated clinicians 1

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

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1194034868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 MAGNOLIA RDG",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711125042",
            "telephone_number": "318-402-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4427 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053620",
            "telephone_number": "318-402-3555",
            "fax_number": "318-861-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARSON INVESTMENTS OF LOUISIANA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-29",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-402-3555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nightingale Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.