Active NPI
Lagniappe Healthcare, LLC
- Skilled Nursing Facility
- Bastrop, LA
National Provider Identifier
1366698300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 291
- Legal business name
- LAGNIAPPE HEALTHCARE, LLC
- Practice address
- 1408 Summerlin LN
Bastrop, LA 71220-2529 - Phone
- (318) 281-5188
- NPI assigned
- Aug 11, 2008
- Last updated
- Aug 11, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Charles Goodwin Gladney Jr.
- Title
- Managing Partner
- Phone
- (318) 281-0078
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 291 | LA | Primary |
Addresses
Primary practice location
1408 Summerlin LN
Bastrop, LA 71220-2529
Mailing address
1523 Texas Ave
Bastrop, LA 71220-4043
Phone (318) 281-0078
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1513229 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081210000857 | LA | Part A Provider - Skilled Nursing Facility | 7911068812 | Practice locations: Bastrop, LA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1366698300. Details of each certification follow.
Skilled nursing facility certification: CCN 195593
- Legal name
- LAGNIAPPE HEALTHCARE LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 2, 2004
- Last certification
- Dec 11, 2024
- Beds
- 112
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Delta Healthcare Management
- Organization structure
- LLC
- Enrollment address
- 1408 Summerlin LN
Bastrop, LA 71220-2529 - Nursing home name
- LAGNIAPPE HEALTHCARE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lagniappe Healthcare
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- May 2, 2004
- Medicare certification status
- Active
- Certified beds
- 112
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D0464314 | Lagniappe Healthcare | Certificate of waiver | Aug 31, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 9
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Gladney 2 LLC | 5% Or Greater Direct Ownership Interest | Jul 9, 2008 | 27% |
| Charles Gladney | 5% Or Greater Direct Ownership Interest | Jul 9, 2008 | 15% |
| 5% Or Greater Indirect Ownership Interest | Jul 9, 2008 | 50% | |
| Operational/Managerial Control | Jul 9, 2008 | 100% | |
| Adp of the SNF | Jul 9, 2008 | ||
| Adp of the SNF | Jan 31, 2025 | ||
| Amanda Boatright | Operational/Managerial Control | Nov 1, 2014 | |
| Adp of the SNF | Nov 1, 2014 | ||
| Delta Healthcare Management, LLC | Operational/Managerial Control | Aug 1, 2009 | 100% |
| Adp of the SNF | Jan 31, 2025 | ||
| Adp of the SNF | Apr 6, 2017 | ||
| Lauren Rogers | Operational/Managerial Control | Feb 18, 1922 | |
| Adp of the SNF | Feb 18, 2022 | ||
| Andrea Gladney | 5% Or Greater Indirect Ownership Interest | Jul 9, 2008 | 50% |
| Indirect Ownership Interest | Jul 9, 2008 | 50% | |
| Delta Healthcare, LLC | 5% Or Greater Direct Ownership Interest | Jul 9, 2008 | 58% |
| Adp of the SNF | Jul 9, 2008 |
Facilities with the same owner 5
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Skilled Nursing Facility
- Bastrop, LA
- NPI 1790061224
Delta Healthcare, LLC
-
- Community Based Hospice Care Agency
- Jena, LA
- NPI 1326861287
Delta Healthcare Management, LLC
-
- Community Based Hospice Care Agency
- Monroe, LA
- NPI 1386834877
Delta Healthcare Management, LLC
-
- Home Health Agency
- Alexandria, LA
- NPI 1134856255
Delta Healthcare Management, LLC
-
- Home Health Agency
- Shreveport, LA
- NPI 1932863917
Delta Healthcare Management, LLC
Practitioners & affiliated clinicians
Practitioners 2
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.
-
- Family Medicine Physician
- Mer Rouge, LA
- NPI 1972690741
-
- Family Medicine Physician
- West Monroe, LA
- NPI 1598738049
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- General Practice Physician
- Bastrop, LA
- NPI 1508848623
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1218412800000",
"number": "1366698300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1523 TEXAS AVE",
"city": "BASTROP",
"state": "LA",
"postal_code": "712204043",
"telephone_number": "318-281-0078",
"fax_number": "318-281-2753"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 SUMMERLIN LN",
"city": "BASTROP",
"state": "LA",
"postal_code": "712202529",
"telephone_number": "318-281-5188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LAGNIAPPE HEALTHCARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-08-11",
"last_updated": "2008-08-11",
"status": "A",
"authorized_official_last_name": "GLADNEY",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "GOODWIN",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "318-281-0078",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "LA",
"license": "291",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1513229",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bastrop, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.