NPIMap

Organization Active NPI

Caldwell Memorial Hospital Inc

Doing business as Winters Clinic

  • Rural Health Clinic/Center
  • Columbia, LA
National Provider Identifier
1639189244
Registry record updated Mar 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
113RHC1 Issued in LA
Legal business name
CALDWELL MEMORIAL HOSPITAL INC
Doing business as
Winters Clinic
Practice address
421 Main St
Columbia, LA 71418-6704
Phone
(318) 649-6157
Fax
(318) 649-5094
NPI assigned
Aug 8, 2006
Last updated
Mar 6, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CALDWELL MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 6, 2020

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

Authorized official

Name
Rhonda Etheridge
Title
Office Manager
Phone
(318) 649-5094

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X LA
Rural Health Clinic/Center 261QR1300X 113RHC1 LA Primary

Addresses

Primary practice location

421 Main St
Columbia, LA 71418-6704

Mailing address

PO Box 1089
Columbia, LA 71418-1089
Phone (318) 649-6157

Other identifiers 1

IdentifierTypeStateIssuer
1943991MedicaidLA

Other names 1

  • Winters Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091218000173 LA Part A Provider - Rural Health Clinic 9638063944 Practice locations: Columbia, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1639189244. Details of each certification follow.

Rural health clinic certification: CCN 193436

Legal name
CALDWELL MEMORIAL HOSPITAL, INC.
Doing business as
WINTERS CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 1, 1997
Last certification
Jun 14, 2022
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Mar 1, 1980 in LA
Enrollment address
421 Main St
Columbia, LA 71418-6704
Related CCNs
190190

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

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Caldwell Memorial Hospital5 organizations share this tax ID, including this one
Part of
Caldwell Memorial Hospital

Other organizations with this tax ID 4

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

Locations

412 Main St
Columbia, LA 71418
Phone (318) 649-6111

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Michael Kramer Individual 5% Or Greater Direct Ownership InterestPresident Dec 12, 2025 50%
Corporate OfficerPresident Dec 12, 2025 50%
W-2 Managing EmployeePresident Dec 12, 2025 25%
Operational/Managerial ControlPresident Dec 12, 2025 25%
Lisa Patrick Individual Corporate OfficerChief Executive Officer May 1, 2008
W-2 Managing EmployeeChief Executive Officer Jul 10, 2005 50%
Operational/Managerial ControlChief Executive Officer May 1, 2008 50%
Jed Christopher Robinson Individual 5% Or Greater Direct Ownership InterestVice President Dec 12, 2025 50%
Corporate OfficerVice President Dec 12, 2025 50%
W-2 Managing EmployeeVice President Dec 12, 2025 25%
Operational/Managerial ControlVice President Dec 12, 2025 25%
Commercial Capital Bank Organization, Columbia, LA Financial institution 5% Or Greater Mortgage Interest Dec 12, 2025 79%

Owners & managing parties with NPI records 1

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

  • Jed Robinson, D.O.
    • Urology Physician
    • Winnsboro, LA
    • NPI 1164730917

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 8

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": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583452800000",
    "number": "1639189244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1089",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714181089",
            "telephone_number": "318-649-6157",
            "fax_number": "318-649-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MAIN ST",
            "city": "COLUMBIA",
            "state": "LA",
            "postal_code": "714186704",
            "telephone_number": "318-649-6157",
            "fax_number": "318-649-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALDWELL MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALDWELL MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2006-08-08",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A",
        "authorized_official_last_name": "ETHERIDGE",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-649-5094"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "113RHC1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1943991",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winters Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Winters Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, LA

Sources for this page

Verify at the official NPI Registry.