NPIMap

Organization Active NPI

Bienville Medical Center Inc

  • Critical Access Hospital
  • Arcadia, LA
National Provider Identifier
1285835561
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
552 Issued in LA
Legal business name
BIENVILLE MEDICAL CENTER INC
Practice address
1175 Pine St Ste 200
Arcadia, LA 71001-3113
Phone
(318) 629-5321
Fax
(318) 226-8205
NPI assigned
May 31, 2007
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Mr. Rock Bordelon
Title
Ceo
Phone
(318) 226-8202

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 552 LA
Critical Access Hospital 282NC0060X 552 LA Primary

Addresses

Primary practice location

1175 Pine St Ste 200
Arcadia, LA 71001-3113

Mailing address

3800 Viking Dr
Bossier City, LA 71111-7403
Phone (318) 629-5321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20210525003479 LA Part A Provider - Critical Access Hospital 5799870119 Receives reassigned benefits from 3 practitioners
Practice locations: Arcadia, LA
O20220806000784 LA Part A Provider - Critical Access Hospital 5799870119 Practice locations: Arcadia, LA
O20230109000848 LA Part B Supplier - Clinic/Group Practice 5799870119 Receives reassigned benefits from 5 practitioners
Practice locations: Arcadia, LA

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1285835561. Details of each certification follow.

Hospital certification: CCN 191320

Legal name
BIENVILLE MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Jan 19, 2005
Last certification
Aug 17, 2022
Beds
21
Ownership / control type
Private (for profit)
Organization structure
CorporationProprietary
Enrollment address
1175 Pine St
Ste 200
Arcadia, LA 71001-3122
Other Hospital Practice Location

Hospital certification: CCN 19Z320

Legal name
BIENVILLE MEDICAL CENTER INC
Organization structure
CorporationProprietary
Enrollment address
1175 Pine St
Ste 200
Arcadia, LA 71001-3122
Other Hospital Practice Location

Care Compare: Hospital

Medicare Care Compare
Listed as
Bienville Medical CenterCCN 191320 · All quality measures
Type
Critical Access Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

504 Texas St
Ste 200
Shreveport, LA 71101
Phone (318) 226-8202

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Donald Cameron Individual Corporate DirectorChief Operating Officer Jul 1, 2007
Corporate Officer Mar 30, 2007
Kirk Matthew Lemoine Individual Corporate OfficerCeo Mar 1, 2024
W-2 Managing EmployeeCeo Aug 21, 2010 100%
Operational/Managerial ControlCeo Mar 1, 2014
Corporate OfficerCeo Mar 1, 2014
W-2 Managing EmployeeCeo Mar 1, 2014
Rock Bordelon Individual 5% Or Greater Direct Ownership InterestOwner Jul 1, 2007 100%
Corporate OfficerOwner Jul 1, 2007
Corporate DirectorOwner Jul 1, 2007
5% Or Greater Direct Ownership Interest Jul 1, 2007
Allegiance Health Management Inc Organization, Bossier City, LA Corporation General Partnership Interest Mar 30, 2007
Five Daughters Inc Organization, Bossier City, LA Corporation General Partnership Interest Mar 30, 2007
Scott Markstrom Individual Corporate Director Dec 2, 2012
Richard Merk Individual Corporate Director Jul 1, 2007
Corporate Officer Mar 30, 2007

Practitioners & affiliated clinicians

Practitioners 10

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.

Affiliated clinicians 13

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1285835561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 VIKING DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711117403",
            "telephone_number": "318-629-5321",
            "fax_number": "318-226-8205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 PINE ST STE 200",
            "city": "ARCADIA",
            "state": "LA",
            "postal_code": "710013113",
            "telephone_number": "318-629-5321",
            "fax_number": "318-226-8205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIENVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "BORDELON",
        "authorized_official_first_name": "ROCK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-226-8202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "LA",
            "license": "552",
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "LA",
            "license": "552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, LA

Sources for this page

Verify at the official NPI Registry.