NPIMap

Organization Active NPI

Christus Health Northern Louisiana

Doing business as Christus Inpatient Rehabilitation Center Shreveport-Bossier

  • Rehabilitation Hospital Unit
  • Shreveport, LA
National Provider Identifier
1356387146
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
CHRISTUS HEALTH NORTHERN LOUISIANA
Doing business as
Christus Inpatient Rehabilitation Center Shreveport-Bossier
Practice address
1035 Margaret PL
Shreveport, LA 71101-4315
Phone
(318) 681-4900
Fax
(318) 681-4427
NPI assigned
Jun 21, 2006
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
Thomas Steen Trawick
Title
Ceo
Phone
(318) 681-5054

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X Primary

Addresses

Primary practice location

1035 Margaret PL
Shreveport, LA 71101-4315

Mailing address

PO Box 843577
Dallas, TX 75284-3577
Phone (800) 756-7999

Other identifiers 1

IdentifierTypeStateIssuer
60952OtherLABLUE CROSS

Other names 1

  • CHRISTUS INPATIENT REHABILITATION CENTER SHREVEPORT-BOSSIER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071203000669 LA Part A Provider - Hospital 8628980554 Practice locations: Shreveport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356387146. Details of each certification follow.

Hospital certification: CCN 19T041

Legal name
CHRISTUS HEALTH NORTHERN LOUISIANA
Doing business as
CHRISTUS INPATIENT REHABILITATION CENTER SHREVEPORT-BOSSIER
Organization structure
CorporationNon-profit
Incorporated
Jun 5, 1913 in LA
Enrollment address
1035 Margaret PL
Shreveport, LA 71101-4315
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Christus Schumpert Health SystemCCN 19T041 · All quality measures
Ownership
Non-profit
Certified
Jul 1, 1989

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2131094Christus Center for Inpatient Rehabilitation1035 Margaret Place, Shreveport, LA 71101Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Christus Schumpert Health System4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1035 Margaret Pl
Shreveport, LA 71101
Phone (318) 681-4900

Ownership & related parties

All disclosed owners & managing parties 10

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

NameRoleSinceShare
Christus Health Organization, Irving, TX Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest May 1, 2024 100%
Casey D Robertson Individual Corporate OfficerCeo Dec 4, 2023
W-2 Managing EmployeeCeo Dec 4, 2023
Christus Northeast Texas and Northern Louisiana Health System Corp Organization, Irving, TX Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 1, 2024 100%
Shannon Dacus Individual Corporate DirectorBoard Member May 1, 2024
Rita Fanning Individual Corporate DirectorBoard Member May 1, 2024
Theresa M Popp Individual Corporate DirectorBoard Member May 1, 2024
Jeb Jones Individual Corporate DirectorBoard Member May 1, 2024
Karla Bounds Individual Corporate OfficerCfo Mar 23, 2026
Mark R Anderson Individual Corporate DirectorBoard Member May 1, 2024
Sonia Acosta Individual Corporate DirectorCorporate Secretary Sep 16, 2024

Owners & managing parties with NPI records 2

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

Facilities with the same owner 49

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

View all 49

Practitioners & affiliated clinicians

Practitioners 1

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 5

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": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1356387146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 843577",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752843577",
            "telephone_number": "800-756-7999",
            "fax_number": "469-282-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 MARGARET PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014315",
            "telephone_number": "318-681-4900",
            "fax_number": "318-681-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH NORTHERN LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "TRAWICK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "STEEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-681-5054"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "60952",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS INPATIENT REHABILITATION CENTER SHREVEPORT-BOSSIER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.