NPIMap

Organization Active NPI

CLHG-Ville Platte LLC

Doing business as Mercy Regional Family Healthcare

  • Rural Health Clinic/Center
  • Ville Platte, LA
National Provider Identifier
1356942155
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLHG-VILLE PLATTE LLC
Doing business as
Mercy Regional Family Healthcare
Practice address
804 E. Main Street
Ville Platte, LA 70586
Phone
(337) 363-5040
Fax
(337) 506-2122
NPI assigned
Nov 6, 2020
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
David Ingram
Title
Ceo
Phone
(337) 363-9486

Specialties & licenses 1

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

Addresses

Primary practice location

804 E. Main Street
Ville Platte, LA 70586

Mailing address

804 E. Main Street
Ville Platte, LA 70586
Phone (337) 363-5040

Other names 1

  • Mercy Regional Family Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201216000776 LA Part A Provider - Rural Health Clinic 4486903309 Practice locations: Ville Platte, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356942155. Details of each certification follow.

Rural health clinic certification: CCN 198538

Legal name
CLHG-VILLE PLATTE LLC
Doing business as
MERCY REGIONAL FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 26, 2021
Last certification
Oct 26, 2021
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
503 Jack Miller Rd
Ville Platte, LA 70586-5607
Related CCNs
190167

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

Other NPIs with the same Medicare PAC ID 8

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

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
19D2213257Mercy Regional Family Healthcare503 Jack Miller Rd, Ville Platte, LA 70586Certificate of waiverFeb 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
CLHG-Ville Platte LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

503 Jack Miller Rd
Ville Platte, LA 70586
Phone (337) 336-5040

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
Rock Bordelon Individual 5% Or Greater Direct Ownership InterestMember Manager Nov 1, 2020 80%
Allegiance Health Management Inc Organization, Bossier City, LA Corporation Limited Partnership Interest Aug 1, 2018
Operational/Managerial Control Nov 1, 2020
Kevin Ardoin Individual Corporate OfficerCeo Jan 1, 2026 100%
W-2 Managing EmployeeCeo Jan 1, 2026 100%
Cameron Investments LLC Organization, Shreveport, LA LLC 5% Or Greater Direct Ownership Interest Nov 1, 2020 16%

Facilities with the same owner 53

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

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1356942155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 E. MAIN STREET",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "70586",
            "telephone_number": "337-363-5040",
            "fax_number": "337-506-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 E. MAIN STREET",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "70586",
            "telephone_number": "337-363-5040",
            "fax_number": "337-506-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-VILLE PLATTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-06",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-363-9486"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Regional Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.