NPIMap

Organization Active NPI

Catahoula Parish Hospital District No 2

  • Federally Qualified Health Center (FQHC)
  • Jonesville, LA
National Provider Identifier
1245629260
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CATAHOULA PARISH HOSPITAL DISTRICT NO 2
Practice address
904 First St
Jonesville, LA 71343-2108
Phone
(318) 339-7265
Fax
(318) 339-7267
NPI assigned
Jan 14, 2015
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Ms. Debra K Miesch, MBA
Title
Ceo
Phone
(318) 389-5727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X LA Primary

Addresses

Primary practice location

904 First St
Jonesville, LA 71343-2108

Mailing address

307 Chisum St
Sicily Island, LA 71368-4807
Phone (318) 339-7265

Other names 1

  • Catahoula Parish Hospital Dist. #2 Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040716000202 LA Part B Supplier - Clinic/Group Practice 8729067434 Receives reassigned benefits from 20 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ferriday, LA; Wisner, LA; Sicily Island, LA; Harrisonburg, LA; Jonesville, LA
O20160311002019 LA Part A Provider - Federally Qualified Health Center (FQHC) 8729067434 Practice locations: Jonesville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1245629260. Details of each certification follow.

Federally qualified health center certification: CCN 191947

Legal name
CATAHOULA PARISH HOSPITAL DISTRICT NO 2
Doing business as
JONESVILLE MEDICAL CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 11, 2016
Last certification
Mar 11, 2016
Ownership / control type
For profit – corporation
Organization structure
OtherNon-profit
Incorporated
Apr 8, 1976 in LA
Enrollment address
904 First St
Jonesville, LA 71343-2108

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Catahoula Parish Hospit7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Serio Blvd
Ferriday, LA 71334
Phone (318) 757-6969

900 Foster St
Jonesville, LA 71343
Phone (318) 339-7265

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Renee Ford Individual W-2 Managing Employee Jan 1, 2015 25%
Debra Miesch Individual 5% Or Greater Direct Ownership InterestCeo Jan 1, 2015 5%
Michelle P Brown Individual W-2 Managing Employee Apr 5, 2001
Catahoula Parish Hospital District No 2 Organization, Sicily Island, LA 5% Or Greater Direct Ownership Interest Jan 1, 2015 25%

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ferriday Family Health CenterFerriday, LA, CCN 191846 Federally qualified health center Operational/Managerial Control Jul 12, 2010

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1245629260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 CHISUM ST",
            "city": "SICILY ISLAND",
            "state": "LA",
            "postal_code": "713684807",
            "telephone_number": "318-339-7265",
            "fax_number": "318-339-7267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 FIRST ST",
            "city": "JONESVILLE",
            "state": "LA",
            "postal_code": "713432108",
            "telephone_number": "318-339-7265",
            "fax_number": "318-339-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATAHOULA PARISH HOSPITAL DISTRICT NO 2",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "MIESCH",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-389-5727",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catahoula Parish Hospital Dist. #2",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Catahoula Parish Hospital Dist. #2",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Jonesville, LA

Sources for this page

Verify at the official NPI Registry.