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Organization Active NPI

Jefferson Manor Nursing & Rehab CNTR LLC

Doing business as Jefferson Manor Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Baton Rouge, LA
National Provider Identifier
1306827449
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
751 Issued in LA
Legal business name
JEFFERSON MANOR NURSING & REHAB CNTR LLC
Doing business as
Jefferson Manor Nursing & Rehabilitation Center
Practice address
9919 Jefferson Hwy
Baton Rouge, LA 70809-2769
Phone
(225) 293-1434
Fax
(225) 291-3254
NPI assigned
Nov 7, 2005
Last updated
Sep 12, 2024By the provider in NPPES
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 751 LA Primary

Addresses

Primary practice location

9919 Jefferson Hwy
Baton Rouge, LA 70809-2769

Mailing address

9919 Jefferson Hwy
Baton Rouge, LA 70809-2769
Phone (225) 293-1434

Other identifiers 1

IdentifierTypeStateIssuer
1521213MedicaidLA

Other names 1

  • Jefferson Manor 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
O20110509000384 LA Part A Provider - Skilled Nursing Facility 7012193014 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306827449. Details of each certification follow.

Skilled nursing facility certification: CCN 195471

Legal name
JEFFERSON MANOR NURSING & REHAB CNTR LLC
Doing business as
JEFFERSON MANOR NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 1, 1998
Last certification
Feb 27, 2025
Beds
122
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Central Management Company, LLC
Organization structure
LLCProprietary
Enrollment address
9919 Jefferson Highway
Jefferson Manor Nursing & Rehabilitation Center
Baton Rouge, LA 70809-2769
Nursing home name
JEFFERSON MANOR NURSING AND REHAB CTR, LLC
Affiliated entity
CENTRAL MANAGEMENT COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Jefferson Manor Nursing and Rehab Ctr, LLCCCN 195471 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
3 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
12294.1 residents per day on average
Chain
Central Management Company21 facilities in the chain
Penalties (3 years)
3Fines totaling $121,628

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Locations

9919 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 293-1434

Ownership & related parties

All disclosed owners & managing parties 23

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 Jun 1, 1997
Teddy D Price Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Individual Adp of the SNF Jan 1, 2010
Organization, Winnfield, LA LLC Adp of the SNF Feb 1, 2001
Jeffrey Lee Cantrell Individual Adp of the SNF Oct 1, 2013
Holly Maumalanga Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 5.64%
Adp of the SNF Mar 31, 2025
Individual Adp of the SNF Jan 1, 2011
Prico, Inc Organization, Winnfield, LA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 1986 49%
Adp of the SNF Feb 1, 2001
Individual Adp of the SNF Mar 11, 2025
Teddy R Price Individual 5% Or Greater Indirect Ownership Interest Dec 1, 1986 75.78%
Operational/Managerial ControlManaging Member of Management Co Dec 1, 1986 100%
Adp of the SNF Feb 1, 2001
Organization, Winnfield, LA LLC, Consulting firm Adp of the SNF Apr 8, 2025
Central Management Company, LLC Organization, Winnfield, LA LLC, Management services company, Chain home office Operational/Managerial Control Dec 1, 1986 100%
Adp of the SNF Apr 8, 2025
Individual Adp of the SNF Mar 11, 2025
Dawn Rogers Individual Adp of the SNF Mar 1, 1993
Individual Adp of the SNF Apr 8, 2025
Sheila M Bolwahnn Individual Adp of the SNF Dec 1, 2008
James Shelton Individual Adp of the SNF Jul 23, 1990
Organization, Lake Charles, LA LLC Adp of the SNF Apr 8, 2025
Organization, Lake Charles, LA LLC, Consulting firm Adp of the SNF Apr 8, 2025
Individual Adp of the SNF Apr 8, 2025
Kisatchie Health, LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 1, 1986 51%
Adp of the SNF Feb 1, 2001
Individual Adp of the SNF Jun 1, 1996
Freda P Zimmerman Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 12.39%
Adp of the SNF Mar 31, 2025

Facilities with the same owner 23

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

View all 23

Practitioners & affiliated clinicians

Practitioners 3

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 3

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": "1306827449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9919 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092769",
            "telephone_number": "225-293-1434",
            "fax_number": "225-291-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9919 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092769",
            "telephone_number": "225-293-1434",
            "fax_number": "225-291-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON MANOR NURSING & REHAB CNTR 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": "751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521213",
            "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": "Jefferson Manor Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jefferson Manor Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.