Organization Active NPI

Avalon Place, LP

Doing business as Avalon Place

  • Nursing Facility Supplies (DME)
  • Monroe, LA
National Provider Identifier
1396754750
Registry record updated Feb 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility Supplies (DME)Taxonomy code 332BN1400X
Legal business name
AVALON PLACE, LP
Doing business as
Avalon Place
Practice address
4385 Old Sterlington Rd
Monroe, LA 71203-2360
Phone
(318) 322-2000
Fax
(318) 812-2143
NPI assigned
Aug 5, 2006
Last updated
Feb 14, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2014

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

Authorized official

Name
Ms. Dawne R Smith
Title
Ceo
Phone
(318) 812-2140

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 435 LA
Nursing Facility Supplies (DME) 332BN1400X Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X

Addresses

Primary practice location

4385 Old Sterlington Rd
Monroe, LA 71203-2360

Mailing address

4385 Old Sterlington Rd
Monroe, LA 71203-2360
Phone (318) 322-2000

Other identifiers 2

IdentifierTypeStateIssuer
3965490001OtherLAPALMETTO GBA DMERC
1521094MedicaidLA

Other names 1

  • Avalon Place Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000059 LA Part A Provider - Skilled Nursing Facility 0143122846 Practice locations: Monroe, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396754750. Details of each certification follow.

Skilled nursing facility certification: CCN 195492

Legal name
AVALON PLACE, LP
Doing business as
AVALON PLACE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 24, 2000
Last certification
Oct 16, 2024
Beds
113
Ownership / control type
Partnership
Multi-facility organization
Paramount Healthcare Consultants
Organization structure
PartnershipProprietary
Enrollment address
4385 Old Sterlington Rd
Monroe, LA 71203-2360
Nursing home name
AVALON PLACE
Affiliated entity
PARAMOUNT HEALTHCARE CONSULTANTS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Avalon PlaceCCN 195492 · All quality measures
Overall star rating
2 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Jul 24, 2000
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11372.5 residents per day on average
Chain
Paramount Healthcare Consultants14 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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
19D0958625Avalon Place4385 Old Sterlington Road, Monroe, LA 71203Certificate of waiverMar 22, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
DCZ Healthcare Investments, LLC Organization, West Monroe, LA Owned by another organization or individual Direct Ownership Interest Jan 1, 2008 24%
Stephen Duck, Cpa PC Organization, Longview, TX Corporation Adp of the SNF Jan 1, 2018
Paramount Healthcare Consultants, LLC Organization, West Monroe, LA Management services company Adp of the SNF Jan 1, 2008
DCZ1 Ventures LLC Organization, West Monroe, LA LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 1, 2008 25%
Adp of the SNF Jan 1, 2008
Kelly Coburn Individual 5% Or Greater Indirect Ownership InterestMemeber Jan 1, 2008 50%
Adp of the SNF Jan 1, 2008
Matthew Randall Hall Individual Operational/Managerial Control Feb 1, 2021
Adp of the SNF Feb 1, 2021
Avalon Place Property, LLC Organization, West Monroe, LA LLC, Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 1, 2008 100%
Adp of the SNF Jan 1, 2008
PKC Investments, LLC Organization, West Monroe, LA Owned by another organization or individual 5% Or Greater Mortgage Interest Jan 1, 2008 75%
Adp of the SNF Jan 1, 2008
Direct Ownership Interest Jan 1, 2008 73%
Dawne R Smith Individual 5% Or Greater Indirect Ownership InterestMember Jan 1, 2008 100%
Adp of the SNF Jan 1, 2008
Paul B Coburn Individual 5% Or Greater Indirect Ownership InterestMember Jan 1, 2008 50%
Adp of the SNF Jan 1, 2008
Amin M El Malah Individual Adp of the SNF Jan 1, 2002

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392336000000",
    "number": "1396754750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4385 OLD STERLINGTON RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032360",
            "telephone_number": "318-322-2000",
            "fax_number": "318-812-2143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4385 OLD STERLINGTON RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032360",
            "telephone_number": "318-322-2000",
            "fax_number": "318-812-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON PLACE, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-02-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAWNE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-812-2140",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "435",
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA DMERC",
            "identifier": "3965490001",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521094",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.