NPIMap

Organization Active NPI

Desoto Hospital Assocation

Doing business as DeSoto Reginal Family Medicine - Logansport

  • Rural Health Clinic/Center
  • Logansport, LA
National Provider Identifier
1457489593
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DESOTO HOSPITAL ASSOCATION
Doing business as
DeSoto Reginal Family Medicine - Logansport
DeSoto Regional Family Medicine - Logansport
Practice address
808 Main Street
Logansport, LA 71049
Phone
(318) 697-2273
Fax
(318) 697-2277
NPI assigned
Mar 1, 2007
Last updated
Dec 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Authorized official

Name
Hallie Deutsch
Title
Credentialing Specialist
Phone
(318) 871-3101

Specialties & licenses 1

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

Addresses

Primary practice location

808 Main Street
Logansport, LA 71049

Mailing address

808 Main Street
Logansport, LA 71049
Phone (318) 697-2273

Other identifiers 3

IdentifierTypeStateIssuer
1445932MedicaidLA
193448OtherLAMEDICARE
5C630OtherLAMDEICARE

Other names 2

  • DeSoto Reginal Family Medicine - Logansport Doing business as
  • DeSoto Regional Family Medicine - Logansport Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080602000779 LA Part B Supplier - Clinic/Group Practice 8022188176 Receives reassigned benefits from 4 practitioners
Practice locations: Logansport, LA
O20100506000748 AR Part A Provider - Rural Health Clinic 2163321829 Practice locations: Logansport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457489593. Details of each certification follow.

Rural health clinic certification: CCN 193448

Legal name
DESOTO HOSPITAL ASSOCIATION
Doing business as
DESOTO REGIONAL FAMILY MEDICINE LOGANSPORT
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 1, 2003
Last certification
May 3, 2023
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1949 in LA
Enrollment address
808 Main Street
Logansport, LA 71049
Related CCNs
190118

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

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Desoto Hospital Associa6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Desoto Hospital Association Organization, Mansfield, LA Corporation 5% Or Greater Direct Ownership Interest Jun 1, 1997 100%
Christopher Davis Individual Corporate DirectorVP of Rural Clinics Nov 15, 2015
Larry T Eppler Individual Corporate OfficerCeo Jul 1, 2013
W-2 Managing EmployeeCeo Jul 1, 2013

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Desoto Regional Health System Zwolle Rural ClinicZwolle, LA, CCN 193449 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 25, 2004
Desoto Regional Family Medicine-MansfieldMansfield, LA, CCN 193480 Rural health clinic 5% Or Greater Direct Ownership Interest Dec 21, 2011

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765497600000",
    "number": "1457489593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MAIN STREET",
            "city": "LOGANSPORT",
            "state": "LA",
            "postal_code": "71049",
            "telephone_number": "318-697-2273",
            "fax_number": "318-697-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MAIN STREET",
            "city": "LOGANSPORT",
            "state": "LA",
            "postal_code": "71049",
            "telephone_number": "318-697-2273",
            "fax_number": "318-697-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO HOSPITAL ASSOCATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A",
        "authorized_official_last_name": "DEUTSCH",
        "authorized_official_first_name": "HALLIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "318-871-3101"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1445932",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "193448",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDEICARE",
            "identifier": "5C630",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeSoto Reginal Family Medicine - Logansport",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DeSoto Regional Family Medicine - Logansport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logansport, LA

Sources for this page

Verify at the official NPI Registry.