NPIMap

Organization Active NPI

Desoto Hospital Association

  • General Acute Care Hospital
  • Mansfield, LA
National Provider Identifier
1467455154
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
229 Issued in LA
Legal business name
DESOTO HOSPITAL ASSOCIATION
Practice address
207 Jefferson St
Mansfield, LA 71052-2603
Phone
(318) 872-4610
Fax
(318) 872-1502
NPI assigned
May 27, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Authorized official

Name
Mr. Todd Eppler
Title
Ceo
Phone
(318) 872-4610

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
General Acute Care Hospital 282N00000X 229 LA Primary

Addresses

Primary practice location

207 Jefferson St
Mansfield, LA 71052-2603

Mailing address

207 Jefferson St
Mansfield, LA 71052-2603
Phone (318) 872-4610

Other identifiers 5

IdentifierTypeStateIssuer
1743283MedicaidLA
04700OtherBLUE CROSS
119678402MedicaidTX
1750131MedicaidLA
90118OtherBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040102000229 LA Part B Supplier - Clinic/Group Practice 2163321829 Receives reassigned benefits from 56 practitioners
1 other NPI on this enrollment
Practice locations: Mansfield, LA
O20080616000692 LA Part A Provider - Hospital 2163321829 Practice locations: Mansfield, LA

Hospital certification: CCN 190118

Legal name
DESOTO HOSPITAL ASSOCIATION
Doing business as
DESOTO REGIONAL HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jan 12, 1968
Last certification
Feb 2, 2022
Beds
34
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1949 in LA
Enrollment address
207 Jefferson St
Mansfield, LA 71052-2603
Other Hospital Practice Location
Hospital subgroups
Acute care

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).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Desoto Regional Health SystemCCN 190118
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Sandra Anderson Individual Corporate DirectorCfo Jan 1, 1989
W-2 Managing EmployeeCfo Aug 28, 2012
Hallie Deutsch Individual W-2 Managing EmployeeCredentialing Specialist Feb 1, 2015
Jill Heard Individual Corporate DirectorSecretary, Board of Directors Mar 1, 2007
Christopher Davis Individual Corporate OfficerCfo Jan 1, 2020
Desoto Hospital Association Organization, Mansfield, LA Non-profit Operational/Managerial Control Aug 28, 2012
Larry T Eppler Individual Corporate OfficerCeo Jul 1, 2013
Operational/Managerial ControlCeo Jul 1, 2013
Deborah Dees Individual Corporate DirectorTreasurer, Board of Directors Mar 1, 2004

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 3

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 LogansportLogansport, LA, CCN 193448 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 1, 1997
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 3

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 57

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

View all 57

Affiliated clinicians 78

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

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1467455154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522603",
            "telephone_number": "318-872-4610",
            "fax_number": "318-872-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 JEFFERSON ST",
            "city": "MANSFIELD",
            "state": "LA",
            "postal_code": "710522603",
            "telephone_number": "318-872-4610",
            "fax_number": "318-872-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "EPPLER",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-872-4610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1743283",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "04700",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119678402",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750131",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "90118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, LA

Sources for this page

Verify at the official NPI Registry.