NPIMap

Organization Active NPI

Christus Health Central Louisiana

Doing business as CHRISTUS Coushatta Ringgold Rural Health Center

  • Rural Health Clinic/Center
  • Ringgold, LA
National Provider Identifier
1205827151
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
551RHC-2 Issued in LA
Legal business name
CHRISTUS HEALTH CENTRAL LOUISIANA
Doing business as
CHRISTUS Coushatta Ringgold Rural Health Center
Practice address
3342 Bienville Rd
Ringgold, LA 71068-3242
Phone
(318) 894-9611
Fax
(318) 894-2100
NPI assigned
Oct 31, 2005
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Monte Wilson
Title
Ceo
Phone
(337) 470-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 551RHC-2 LA Primary

Addresses

Primary practice location

3342 Bienville Rd
Ringgold, LA 71068-3242

Mailing address

PO Box 847329
Dallas, TX 75284-7329
Phone (800) 756-7999

Other identifiers 1

IdentifierTypeStateIssuer
1444651MedicaidLA

Other names 1

  • CHRISTUS Coushatta Ringgold Rural Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041217000169 LA Part A Provider - Rural Health Clinic 4688570955 Practice locations: Ringgold, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205827151. Details of each certification follow.

Rural health clinic certification: CCN 193447

Legal name
CHRISTUS HEALTH CENTRAL LOUISIANA
Doing business as
CHRISTUS COUSHATTA RINGGOLD RURAL HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 1, 2003
Last certification
Dec 4, 2018
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Nov 19, 1946 in LA
Enrollment address
3342 Bienville Rd
Ringgold, LA 71068-3242

Other NPIs with the same Medicare PAC ID 9

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

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
19D0720121Christus Coushatta Ringgold Rural Health Clinic3342 Bienville Road, Ringgold, LA 71068AccreditationDec 6, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

3342 Bienville Rd
Ringgold, LA 71068
Phone (318) 894-9611

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Jason Miller Individual Corporate OfficerCfo Aug 28, 2023
Christus Health Organization, Irving, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest Jan 1, 2005 100%
Aloysia C Ducote Individual Corporate Director Jan 1, 2014
Sonia Acosta Individual Corporate DirectorCorporate Secretary Sep 16, 2024
Monte Wilson Individual Corporate OfficerCeo May 12, 2021
W-2 Managing EmployeeCeo May 12, 2021
Fadi V Nasrallah Individual Corporate DirectorBoard Member Feb 22, 2024

Facilities with the same owner 47

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

View all 47

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1205827151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847329",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847329",
            "telephone_number": "800-756-7999",
            "fax_number": "469-282-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3342 BIENVILLE RD",
            "city": "RINGGOLD",
            "state": "LA",
            "postal_code": "710683242",
            "telephone_number": "318-894-9611",
            "fax_number": "318-894-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH CENTRAL LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-470-2100"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "551RHC-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1444651",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS Coushatta Ringgold Rural Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS Coushatta Ringgold Rural Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ringgold, LA

Sources for this page

Verify at the official NPI Registry.