Specialty Rehabilitation Hospital, L.L.C.

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

630 Issued in LA

Legal business name

SPECIALTY REHABILITATION HOSPITAL, L.L.C.

Doing business as

Specialty Rehabilitation Hospital

Practice address

1110 Ringgold Avenue
Suite B
Coushatta, LA 71019

Phone

(318) 932-1770

Fax

(318) 932-1772

NPI assigned

Sep 26, 2007

Last updated

Jul 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Craig Ball

Title

Governing Board Chairman / Ceo

Phone

(337) 238-4449

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Specialty Rehabilitation Hospital Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1437346186. Details of each certification follow.

• CCN 193080 Hospital · Active · Details

Hospital certification: CCN 193080

Legal name

SPECIALTY REHABILITATION HOSPITAL, L.L.C.

Certification status

Active

Provider type (POS)

Hospital – Rehabilitation

Participating since

Jul 16, 2002

Last certification

Jan 18, 2023

Beds

12

Ownership / control type

Private (for profit)

Most recent change of ownership

Aug 17, 2007 (1 total)

Organization structure

LLCProprietary

Enrollment address

1110 Ringgold Ave B
Coushatta, LA 71019-9073
Main/Primary Hospital Location

Hospital subgroups

Rehabilitation

Listed as

Specialty Rehabilitation HospitalCCN 193080 · All quality measures

Ownership

For profit

Certified

Jul 16, 2002

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

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.

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.

• Joshua Ray Cason, MD

  • Family Medicine Physician
  • Coushatta, LA
  • NPI 1245466408
  NPD (past)

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Joshua Ray Cason, MD

  • Family Medicine Physician
  • Coushatta, LA
  • NPI 1245466408

  Inpatient rehabilitation facility

  Care Compare affiliation
• Gavin F Chico, M. D.

  • Internal Medicine Physician
  • Coushatta, LA
  • NPI 1740261650

  Inpatient rehabilitation facility

  Care Compare affiliation
• Wyche Taylor Coleman Jr., M.D.

  • Family Medicine Physician
  • Coushatta, LA
  • NPI 1710984513

  Inpatient rehabilitation facility

  Care Compare affiliation
• Sarah Herbel, MD

  • Emergency Medicine Physician
  • Coushatta, LA
  • NPI 1508488024

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1437346186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 309",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-1770",
            "fax_number": "318-932-1772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 RINGGOLD AVENUE",
            "address_2": "SUITE B",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-1770",
            "fax_number": "318-932-1772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY REHABILITATION HOSPITAL, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "BALL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "CRAIG",
        "authorized_official_title_or_position": "GOVERNING BOARD CHAIRMAN / CEO",
        "authorized_official_telephone_number": "337-238-4449",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "LA",
            "license": "630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702021",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "193080",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Rehabilitation Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Daniel Edward Rose, DDS
• Saint Mark Hospice and Palliative Care LLC
• Rebecca Shaffer, LCSW
• Ranette Smith
• Christopher S. Snead, MD
• Synergy Home Care Northwestern Region Inc (CenterWell Home Health)
• The Heart of Nursing
• The Will of God Ministries Outreach Program
• The Will of God Ministries Outreach Program
• The Will of God Ministries Outreach Program

• Rehabilitation Hospital in Coushatta, LA
• Providers in Coushatta, LA by specialty
• Rehabilitation Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.

Verify at the official NPI Registry.