NPIMap

Organization Active NPI

Abbeville General Hospital

  • Urgent Care Clinic/Center
  • Abbeville, LA
National Provider Identifier
1619458247
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ABBEVILLE GENERAL HOSPITAL
Practice address
2421 Alonzo Street
Abbeville, LA 70510-4008
Phone
(337) 892-6919
Fax
(337) 892-6920
NPI assigned
Aug 22, 2018
Organization subpart
Yes
Parent organization
ABBEVILLE GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

Name
Demetria Martin, RHIA, CCS
Title
Director of Bus Off and PT Access
Phone
(337) 898-6525

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2421 Alonzo Street
Abbeville, LA 70510-4008

Mailing address

118 N Hospital Dr
Abbeville, LA 70510-4039
Phone (337) 893-5466

Other identifiers 2

IdentifierTypeStateIssuer
756231OtherLAMEDICARE PTAN#
2488368MedicaidLA

Other names 1

  • Abbeville Urgent Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190123000743 LA Part B Supplier - Clinic/Group Practice 8325933872 Receives reassigned benefits from 18 practitioners
Practice locations: Abbeville, LA

Other NPIs with the same Medicare PAC ID 6

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2152755Abbeville Urgent Care2421 Alonzo St, Abbeville, LA 70510Certificate of waiverAug 15, 2026

National Provider Directory

National Provider Directory
Part of
Abbeville General Hosp Phcy

Locations

2602 North Dr
Abbeville, LA 70510
Phone (337) 893-1101

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Erath-Delcambre Community Care ClinicErath, LA, CCN 193490 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1966

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 67

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

View all 67

NPI Registry JSON

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1619458247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N HOSPITAL DR",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705104039",
            "telephone_number": "337-893-5466",
            "fax_number": "337-893-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 ALONZO STREET",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705104008",
            "telephone_number": "337-892-6919",
            "fax_number": "337-892-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBEVILLE GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ABBEVILLE GENERAL HOSPITAL",
        "enumeration_date": "2018-08-22",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DEMETRIA",
        "authorized_official_title_or_position": "DIRECTOR OF BUS OFF AND PT ACCESS",
        "authorized_official_telephone_number": "337-898-6525",
        "authorized_official_credential": "RHIA, CCS"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN#",
            "identifier": "756231",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2488368",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Abbeville Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abbeville, LA

Sources for this page

Verify at the official NPI Registry.