NPIMap

Organization Active NPI

St. James Parish Hosp. Serv. Dist.

  • Medicare Defined Swing Bed Hospital Unit
  • Lutcher, LA
National Provider Identifier
1649319294
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
164 Issued in LA
Legal business name
ST. JAMES PARISH HOSP. SERV. DIST.
Practice address
1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone
(225) 869-5512
Fax
(225) 869-5271
NPI assigned
Feb 6, 2007
Last updated
Jun 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Authorized official

Name
Mrs. Tracy L George
Title
Chief Financial Offider
Phone
(225) 746-2901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medicare Defined Swing Bed Hospital Unit 275N00000X 164 LA Primary

Addresses

Primary practice location

1645 Lutcher Ave
Lutcher, LA 70071-5150

Mailing address

1645 Lutcher Ave
Lutcher, LA 70071-5150
Phone (225) 869-5512

Other identifiers 2

IdentifierTypeStateIssuer
1720224MedicaidLA
33768OtherLABLUE CROSS SWING BED

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220806000725 LA Part A Provider - Critical Access Hospital 3476459850 Practice locations: Lutcher, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649319294. Details of each certification follow.

Hospital certification: CCN 19Z305

Legal name
ST. JAMES PARISH HOSP SERV DIST
Organization structure
OtherNon-profit
Enrollment address
1645 Lutcher Ave
Lutcher, LA 70071-5150
Hospital Swing-Bed Unit

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Leslie J Loup Individual Corporate Director Jun 26, 2019
Wayne Waguespack Individual Corporate Director Feb 19, 1992
St. James Parish Hosp Serv Dist Organization, Lutcher, LA Non-profit Operational/Managerial Control Apr 15, 2008
Mary Pratt Individual Corporate DirectorCeo Dec 22, 2007
W-2 Managing EmployeeCeo Dec 22, 2007
Randall Poche Individual Corporate Director Jul 21, 2021
Ethan Bland Individual W-2 Managing EmployeeChief Financial Officer Jul 1, 2025
Wilbur Reynaud Individual Corporate Director May 21, 1986
Tracy George Individual Corporate DirectorChief Financial Officer Dec 22, 2007
W-2 Managing EmployeeCfo Dec 22, 2007

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
St. James Parish HospitalLutcher, LA, CCN 191305 Hospital Operational/Managerial Control Apr 15, 2008

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1649319294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-869-5512",
            "fax_number": "225-869-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 LUTCHER AVE",
            "city": "LUTCHER",
            "state": "LA",
            "postal_code": "700715150",
            "telephone_number": "225-869-5512",
            "fax_number": "225-869-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JAMES PARISH HOSP. SERV. DIST.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "GEORGE",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFIDER",
        "authorized_official_telephone_number": "225-746-2901",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "LA",
            "license": "164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720224",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS SWING BED",
            "identifier": "33768",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutcher, LA

Sources for this page

Verify at the official NPI Registry.