NPIMap

Organization Active NPI

Allen Parish Hospital District No 3

Doing business as Allen Parish Hospital Rural Health Center

  • Rural Health Clinic/Center
  • Kinder, LA
National Provider Identifier
1285785089
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
205 Issued in LA
Legal business name
ALLEN PARISH HOSPITAL DISTRICT NO 3
Doing business as
Allen Parish Hospital Rural Health Center
Practice address
108 6TH Ave BLDG B
Kinder, LA 70648-3187
Phone
(337) 738-9494
Fax
(337) 738-9449
NPI assigned
Jan 16, 2007
Last updated
Sep 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLEN PARISH HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Jacqueline Reviel
Title
Ceo
Phone
(337) 738-9478

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 205 LA Primary

Addresses

Primary practice location

108 6TH Ave BLDG B
Kinder, LA 70648-3187

Mailing address

108 6TH Avenue
Kinder, LA 70648-1670
Phone (337) 738-4721

Other names 1

  • Allen Parish Hospital Rural Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RHClinic@APHRHC.drchronodirect.com Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060630000069 LA Part A Provider - Rural Health Clinic 3274431341 Practice locations: Kinder, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285785089. Details of each certification follow.

Rural health clinic certification: CCN 193470

Legal name
ALLEN PARISH HOSPITAL DISTRICT NO 3
Doing business as
ALLEN PARISH HOSPITAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 16, 2006
Last certification
Aug 20, 2018
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
108 6TH Ave BLDG B
Allen Parish Hospital Rural Health Clinic
Kinder, LA 70648-3187
Related CCNs
190133

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Khudr Burjak MD8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

108 6th Ave
#B
Kinder, LA 70648

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/allen-5c267a32
  • Direct secure messaging: rhclinic@aphrhc.drchronodirect.com

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
Sadie Lantron Individual W-2 Managing EmployeeDirector Nov 1, 2022
Kandace Fontenot Individual Corporate DirectorCeo Sep 25, 2014
W-2 Managing EmployeeDirector Oct 5, 2015
Allen Parish Hospital District No 3 Organization, Kinder, LA Other Apr 14, 1966 100%
Jacqueline Reviel Individual Corporate DirectorCeo Sep 25, 2014

Owners & managing parties with NPI records 4

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
Allen Parish Home HealthKinder, LA, CCN 197748 Home health agency Other (100%) Dec 27, 1995

Owned or controlled facilities with NPI records 1

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

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1285785089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 6TH AVENUE",
            "city": "KINDER",
            "state": "LA",
            "postal_code": "706481670",
            "telephone_number": "337-738-4721",
            "fax_number": "337-738-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 6TH AVE BLDG B",
            "city": "KINDER",
            "state": "LA",
            "postal_code": "706483187",
            "telephone_number": "337-738-9494",
            "fax_number": "337-738-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN PARISH HOSPITAL DISTRICT NO 3",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLEN PARISH HOSPITAL",
        "enumeration_date": "2007-01-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "REVIEL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-738-9478"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RHClinic@APHRHC.drchronodirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "108 N 6th St",
            "city": "Kinder",
            "state": "LA",
            "country_code": "US",
            "postal_code": "706483519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Allen Parish Hospital Rural Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allen Parish Hospital Rural Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kinder, LA

Sources for this page

Verify at the official NPI Registry.