Individual provider Active NPI

Rachael Garrison, PA-C

  • Physician Assistant
  • Leesville, LA
National Provider Identifier
1528511615
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.327545 Issued in LA
Practice address
1020 W Fertitta Blvd
Leesville, LA 71446-4645
Phone
(337) 239-9041
NPI assigned
Jul 26, 2016
Last updated
Jul 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2114 KY
Physician Assistant 363A00000X PA.327545 LA Primary

Addresses

Primary practice location

1020 W Fertitta Blvd
Leesville, LA 71446-4645

Mailing address

248 Smithbrook Rd
Leesville, LA 71446-2156
Phone (270) 737-1212

Other practice location 1

1585 3rd St
Fort Polk, LA 71459-5102
Phone (337) 531-3118

Other practice location 2

248 Smithbrook Rd
Leesville, LA 71446-2156
Phone (205) 317-8158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160920002026 KY Practitioner - Physician Assistant 1456648328 Reassigns benefits to 1 organization
I20210831001810 LA Practitioner - Physician Assistant 1456648328 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glen D. Hurlston, M.D., ApmcGroup PAC ID 3779557541, 26 clinicians
South Central Physicians PLLCGroup PAC ID 6507195492, 41 clinicians

Practice addresses (Care Compare)

1020 Fertitta Blvd
Leesville, LA 71446-4645

1020 W Fertita Blvd
Leesville, LA 71446-4645
Phone (337) 239-9041

165 Beech Springs Rd
Jonesboro, LA 71251-2013
Phone (318) 259-4435

600 S Pine St
Deridder, LA 70634-4942
Phone (337) 462-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2114KYMDPhysician Assistant
PA.327545LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Sep 1, 2020 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince Aug 25, 2021 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Aug 25, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients

Locations

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1528511615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 SMITHBROOK RD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714462156",
            "telephone_number": "270-737-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 W FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464645",
            "telephone_number": "337-239-9041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1585 3rd St",
            "address_purpose": "LOCATION",
            "city": "Fort Polk",
            "state": "LA",
            "postal_code": "714595102",
            "country_code": "US",
            "telephone_number": "337-531-3118",
            "fax_number": "337-531-3366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "248 Smithbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Leesville",
            "state": "LA",
            "postal_code": "714462156",
            "country_code": "US",
            "telephone_number": "205-317-8158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARRISON",
        "first_name": "RACHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2114",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.327545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.