NPIMap

Organization Active NPI

South Regional Personal Care Service, LLC

  • Community Based Hospice Care Agency
  • Baton Rouge, LA
National Provider Identifier
1366955809
Registry record updated Nov 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
License
2203783544 Issued in LA
Legal business name
SOUTH REGIONAL PERSONAL CARE SERVICE, LLC
Practice address
10319 Old Hammond Hwy Ste B1
Baton Rouge, LA 70816-8288
Phone
(225) 367-1467
Fax
(225) 456-5094
NPI assigned
Nov 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2017

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

Authorized official

Name
Shannah HickersonNPI 1477200368
Title
Owner
Phone
(225) 367-1646

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X 2203783544 LA Primary

Addresses

Primary practice location

10319 Old Hammond Hwy Ste B1
Baton Rouge, LA 70816-8288

Mailing address

10319 Old Hammond Hwy Ste B1
Baton Rouge, LA 70816-8288
Phone (225) 367-1467

Other identifiers 1

IdentifierTypeStateIssuer
2203783544MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
South Regional Personal Care Service LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

10319 Old Hammond Hwy
Ste B1
Baton Rouge, LA 70816
Phone (225) 367-1646

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510012800000",
    "number": "1366955809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10319 OLD HAMMOND HWY STE B1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168288",
            "telephone_number": "225-367-1467",
            "fax_number": "225-456-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10319 OLD HAMMOND HWY STE B1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168288",
            "telephone_number": "225-367-1467",
            "fax_number": "225-456-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH REGIONAL PERSONAL CARE SERVICE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2017-11-07",
        "status": "A",
        "authorized_official_last_name": "HICKERSON",
        "authorized_official_first_name": "SHANNAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-367-1646"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "LA",
            "license": "2203783544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2203783544",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.