NPIMap

Organization Active NPI

West Carroll Health Systems LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Oak Grove, LA
National Provider Identifier
1255455390
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
Legal business name
WEST CARROLL HEALTH SYSTEMS LLC
Practice address
706 Ross St
Oak Grove, LA 71263-9798
Phone
(318) 428-4964
Fax
(318) 428-9681
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Authorized official

Name
Raymond Morris
Title
Administrator
Phone
(318) 428-3237

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X LA Primary

Addresses

Primary practice location

706 Ross St
Oak Grove, LA 71263-9798

Mailing address

706 Ross St
Oak Grove, LA 71263-9798
Phone (318) 428-4964

Other names 1

  • west carroll hospital swing bed Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230605001961 LA Part A Provider - Critical Access Hospital 5294627774 Receives reassigned benefits from 8 practitioners
Practice locations: Oak Grove, LA

Hospital certification: CCN 19Z327

Legal name
WEST CARROLL HEALTH SYSTEMS, LLC
Doing business as
WEST CARROLL MEMORIAL HOSPITAL
Organization structure
LLCProprietary
Incorporated
Oct 28, 2002 in LA
Enrollment address
706 Ross St
Oak Grove, LA 71263-9798
Hospital Swing-Bed Unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory

Member of 1

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

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
West Carroll Health Systems, LLC Organization, Oak Grove, LA LLC, For-profit 5% Or Greater Direct Ownership Interest Dec 1, 2002 100%
Raymond Morris Individual 5% Or Greater Direct Ownership Interest Dec 1, 2002 80%
Corporate OfficerCeo Dec 1, 2002 100%
Corporate Director Dec 1, 2002 100%
Amanda D Grey Individual 5% Or Greater Direct Ownership Interest Dec 1, 2002 10%
W-2 Managing EmployeeAdministrator Dec 2, 2002 100%
Shannon Dawn Poche Individual Operational/Managerial ControlOffice Manager Jul 1, 2021 100%

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 5

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

FacilityTypeRoleSince
West Carroll Home HealthOak Grove, LA, CCN 197135 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2002
Dec 1, 2002
Lake Providence Medical ClinicLake Providence, LA, CCN 193999 Rural health clinic 5% Or Greater Direct Ownership Interest Dec 1, 2002
Oak Grove Medical ClinicOak Grove, LA, CCN 193984 Rural health clinic 5% Or Greater Direct Ownership Interest Dec 1, 2002
West Carroll Medical ClinicOak Grove, LA, CCN 193992 Rural health clinic 5% Or Greater Direct Ownership Interest Dec 1, 2002
Community Medical ClinicOak Grove, LA, CCN 193409 Rural health clinic 5% Or Greater Direct Ownership Interest Dec 1, 2002

Owned or controlled facilities with NPI records 5

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 8

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

Affiliated clinicians 4

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": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1255455390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639798",
            "telephone_number": "318-428-4964",
            "fax_number": "318-428-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 ROSS ST",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712639798",
            "telephone_number": "318-428-4964",
            "fax_number": "318-428-9681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CARROLL HEALTH SYSTEMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-428-3237"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "west carroll hospital swing bed",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Grove, LA

Sources for this page

Verify at the official NPI Registry.