Villa Feliciana Medical Complex
Organization Active NPI Long Term Care Hospital · Jackson, LA
NPI 1639228174 · NPPES record last updated May 6, 2008
Key facts
- NPI
- 1639228174
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Long Term Care Hospital 282E00000X
- Legal business name
- VILLA FELICIANA MEDICAL COMPLEX
- Practice address
- 5002 Hwy 10
Jackson, LA 70748 - Phone
- (225) 634-4017
- Fax
- (225) 634-4191
- NPI assigned
- Jan 10, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. James R. O'Rear
- Title
- Long Term Care Hospital Admin.
- Phone
- (225) 634-4017
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Member of 1
Practitioners 3
-
Chaillie P Daniel, M.D.
-
David K Jackson, PHD MSCP
-
Ro Risa Reina, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Villa Feliciana Medical Complex |
Skilled nursing facility | Operational/Managerial Control (100%) | Oct 1, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040325001248 | LA | Part B Supplier - Clinic/Group Practice | 4486546405 |
Receives reassigned benefits from 1 practitioner Practice locations: Jackson, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Hospital | 282E00000X | LA | Yes |
Addresses
Primary practice location
5002 Hwy 10
Jackson, LA 70748
Mailing address
5002 Highway 10
Jackson, LA 70748-0438
Phone (225) 634-4017
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 118326 | Other | LA | LAB |
| 5CF42 | Other | LA | MEDICARE PART B |
| 1734641 | Other | LA | HOSPITAL |
| 1551465 | Medicaid | LA | |
| 5CK77 | Other | LA | X-RAY |
Other providers in Jackson, LA
- Salonda Thomas
- Michael Kevin Tomb
- Rhonda Bourgeois Tomb
- Elizabeth Tycer
- Villa Feliciana Medical Complex
- Jacqueline Michel Whitmore
All providers in Jackson, LA · Long Term Care Hospital in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2008. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.