Lagniappe Homecare Northern Louisana Inc
Organization Active NPI Home Health Agency · Winnfield, LA
NPI 1609844596 · NPPES record last updated Jan 11, 2019
Key facts
- NPI
- 1609844596
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 245 (LA)
- Legal business name
- LAGNIAPPE HOMECARE NORTHERN LOUISANA INC
- Practice address
- 206 N Bevill St
Winnfield, LA 71483-3231 - Phone
- (318) 628-3807
- Fax
- (318) 628-3818
- NPI assigned
- Mar 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Maureen J Wise
- Title
- Adminsitrator
- Phone
- (318) 628-3807
Facilities with the same owner 1
Affiliated clinicians 18
-
Bryant Anthony Acosta, PA-C
-
Mark Blackwelder, M.D.
-
Lacey Lamkin Brown, FNP-C
-
Kimberly G. Brunson, APRN, FNP-BC
-
Eric Charles Dupree, M.D.
-
Bobby Taylor Ensminger, M.D.
-
Stacy D Ferrell, APRN
-
Julio E Iglesias, M.D.
-
Candice S Leach, FNP-C
-
Sheila Mariano, M.D.
-
Shane M McVay, FNP
-
Terri Lynn Roberts, FNP-C
-
Mark Vance Shelton, M.D.
-
William J Slusher, M.D.
-
Dana Blalock Williams, APRN
Medicare Care Compare: Home health agency
- Listed as
- Lagniappe Homecare Northern Louisiana
- Overall star rating
- ★★★★☆ 3.5 of 5
- Ownership
- Proprietary
- Certified
- Feb 21, 1986
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Home health agency certification: CCN 197197
- Legal name
- LAGNIAPPE HOMECARE NORTHERN LOUISANA INC
- Doing business as
- LAGNIAPPE HOMECARE NORTHERN LOUISIANA
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Feb 21, 1986
- Last certification
- Jul 15, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation · Proprietary
- Incorporated
- Mar 1, 1986 in LA
- Enrollment address
- 2310 Commons Court
Ste 2W
Ruston, LA 71270
All disclosed owners & managing parties 2
| Name | Role | Since | Share |
|---|---|---|---|
| Teddy R Price |
5% Or Greater Indirect Ownership Interest | Feb 1, 2018 | 100% |
| Corporate Director |
Feb 1, 2018 | 100% | |
| Operational/Managerial Control |
Feb 1, 2018 | ||
| Lagniappe Health Corporation |
5% Or Greater Direct Ownership Interest | Feb 1, 2018 | 100% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120316000534 | LA | Part a Provider - Home Health Agency | 4880853415 | Practice locations: Ruston, LA; Winnfield, LA |
National Provider Directory
Locations
2310 Common Ct
Ste 2W
Ruston, LA 71270
Phone (318) 202-2730
206 N Bevill St
Winnfield, LA 71483
Phone (318) 628-3807
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 245 | LA | Yes |
Addresses
Primary practice location
206 N Bevill St
Winnfield, LA 71483-3231
Mailing address
206 N Bevill St
Winnfield, LA 71483-3231
Phone (318) 628-3807
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1401978 | Medicaid | LA |
Other providers in Winnfield, LA
- Just Health
- Kanome Services, Inc.
- John W. Kevill
- Zoe Madison Lacombe
- Lagniappe Homecare Alexandria LLC
- Lauren Layton
- Tonya Corley Ledbetter
- James S Lee
- Kristal D Lee
- Charles Little
All providers in Winnfield, LA · Home Health Agency in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.