NPIMap

Organization Active NPI

Garden Park Nursing & Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Shreveport, LA
National Provider Identifier
1235110438
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
398 Issued in LA
Legal business name
GARDEN PARK NURSING & REHABILITATION CENTER, LLC
Practice address
9111 Linwood Ave
Shreveport, LA 71106-6509
Phone
(318) 688-0961
Fax
(318) 686-9287
NPI assigned
Nov 7, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Mr. Teddy Ray Price
Title
Managing Member
Phone
(318) 628-4116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 398 LA Primary

Addresses

Primary practice location

9111 Linwood Ave
Shreveport, LA 71106-6509

Mailing address

PO Box 6479
Shreveport, LA 71136-6479
Phone (318) 688-0961

Other identifiers 1

IdentifierTypeStateIssuer
1517798MedicaidLA

Other names 1

  • Garden Park Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000321 LA Part A Provider - Skilled Nursing Facility 3577604669 Practice locations: Shreveport, LA

Skilled nursing facility certification: CCN 195248

Legal name
GARDEN PARK NURSING & REHABILITATION CENTER, LLC
Doing business as
GARDEN PARK NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Dec 6, 1989
Last certification
Aug 8, 2024
Beds
160
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Central Management Co.
Organization structure
LLCProprietary
Enrollment address
9111 Linwood Ave
Shreveport, LA 71106-6509
Nursing home name
GARDEN PARK NURSING & REHAB CTR, LLC
Affiliated entity
CENTRAL MANAGEMENT COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Garden Park Nursing & Rehab CTR, LLCCCN 195248
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Dec 6, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
160137.4 residents per day on average
Chain
Central Management Company21 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 27

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

NameRoleSinceShare
Individual Adp of the SNF Apr 3, 2025
Direct Ownership Interest Mar 31, 2025 1.25%
Indirect Ownership Interest Mar 31, 2025 1.25%
Individual Adp of the SNF Mar 11, 2025
Teddy D Price Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Individual Adp of the SNF Jun 23, 2025
Jeffrey Lee Cantrell Individual Adp of the SNF Oct 1, 2013
Jennifer Peters Individual Adp of the SNF Mar 11, 2025
Teddy R Price Individual 5% Or Greater Direct Ownership Interest Oct 1, 1983 50.83%
5% Or Greater Indirect Ownership Interest Oct 1, 1983 15%
Operational/Managerial ControlManaging Member/Indirect Ownersh Oct 1, 1983 100%
Adp of the SNF Feb 1, 2001
Direct Ownership Interest Jun 16, 2020 50.83%
Indirect Ownership Interest Mar 1, 1979 15%
Central Management Company, LLC Organization, Winnfield, LA LLC, Management services company, Chain home office Operational/Managerial Control Dec 6, 1989 100%
Adp of the SNF Jun 23, 2025
Organization, Lake Charles, LA LLC Adp of the SNF Apr 3, 2025
Dawn Rogers Individual Adp of the SNF Mar 1, 1993
Individual Adp of the SNF Apr 3, 2025
Direct Ownership Interest Mar 31, 2025 0.28%
Individual Adp of the SNF Jun 1, 1997
Sheila M Bolwahnn Individual Adp of the SNF Dec 1, 2008
James Shelton Individual Adp of the SNF Jul 23, 1990
Individual Adp of the SNF Jun 1, 1996
Kisatchie Industries LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jul 25, 2016 25%
Adp of the SNF Feb 1, 2001
Organization, Lake Charles, LA LLC, Consulting firm Adp of the SNF Apr 3, 2025
Individual Adp of the SNF Apr 3, 2025
Direct Ownership Interest Mar 31, 2025 0.31%
Individual Adp of the SNF Jan 1, 2010
Organization, Winnfield, LA LLC, Consulting firm Adp of the SNF Jun 23, 2025
Individual Adp of the SNF Jan 1, 2011
Organization, Winnfield, LA LLC, Holding company Adp of the SNF Feb 1, 2001
Individual Adp of the SNF Apr 3, 2025
Individual Adp of the SNF Apr 3, 2025
Direct Ownership Interest Mar 31, 2025 0.1%
Indirect Ownership Interest Mar 31, 2025 0.1%
Kisatchie Health, LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Oct 1, 1983 15%
Adp of the SNF Feb 1, 2001
Teddy R & Susan R Burnum Price Inv TR Fbo Jacqueline E Price Et Al Organization, Winnfield, LA 5% Or Greater Indirect Ownership Interest Jul 25, 2016 25%
Adp of the SNF Feb 1, 2001
Freda P Zimmerman Individual 5% Or Greater Direct Ownership Interest Jun 16, 2020 6.66%
Adp of the SNF Jun 16, 2020

Facilities with the same owner 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 2

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

Affiliated clinicians 2

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1235110438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6479",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711366479",
            "telephone_number": "318-688-0961",
            "fax_number": "318-686-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 LINWOOD AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711066509",
            "telephone_number": "318-688-0961",
            "fax_number": "318-686-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN PARK NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-628-4116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517798",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Garden Park Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.