NPIMap

Concordia Parish Hospital Service District Number One

Organization Active NPI Rural Health Clinic/Center · Ferriday, LA

NPI 1679513600 · NPPES record last updated Oct 5, 2022

Key facts

NPI
1679513600
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Practice address
204 Serio Blvd
Ferriday, LA 71334-2015
Phone
(318) 757-8010
Fax
(318) 757-9501
NPI assigned
Jun 7, 2006
Organization subpart
No

Authorized official

Name
Nekeisha Lashay Smith
Title
Administrator
Phone
(318) 719-3636

Owners & managing parties with NPI records 4

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

Owned or controlled facilities with NPI records 3

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

Other NPIs with the same Medicare PAC ID 4

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

Corporate family (same tax ID) 4

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

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

Facilities with the same owner 3

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

Practitioners 63

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

View all 63

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1004138Trinity Medical Ferriday Clinic
204 Serio Boulevard, Ferriday, LA 71334		Certificate of waiverSep 18, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in LA

Rural health clinic certification: CCN 198514

Legal name
CONCORDIA PARISH HOSPITAL SERVICE DISTRICT NUMBER ONE
Doing business as
TRINITY MEDICAL FERRIDAY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 14, 2019
Last certification
Aug 14, 2025
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Enrollment address
204 Serio Blvd
Ferriday, LA 71334-2015
Related CCNs
191318

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
Concordia Parish Hospital Service District Number One
Organization · Ferriday, LA
Non-profit 		5% Or Greater Direct Ownership Interest May 1, 2015 100%
Operational/Managerial Control May 1, 2015 100%
Connie Vigil
Individual 		Corporate Director Aug 12, 2019
Spencer Holder
Individual 		Corporate Officer
Cfo		 Aug 10, 2016
Operational/Managerial Control Feb 5, 2021
Nekeisha Smith
Individual 		Corporate Officer
Ceo		 Feb 5, 2021
W-2 Managing Employee Feb 5, 2021
Operational/Managerial Control
Ceo		 Feb 5, 2021

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Trinity Medical
Ferriday, LA · CCN 191318		 Hospital Operational/Managerial Control Jun 1, 1966
Trinity Medical
Ferriday, LA · CCN 19Z318		 Hospital 5% Or Greater Indirect Ownership Interest
Operational/Managerial Control		 Nov 1, 2004
Nov 1, 2004
Trinity Medical Vidalia Clinic
Vidalia, LA · CCN 198502		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jan 12, 2021
Jan 12, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040216001076 LA Part B Supplier - Clinic/Group Practice 4587559935 Receives reassigned benefits from 7 practitioners
Practice locations: Ferriday, LA
O20180823000208 LA Part a Provider - Rural Health Clinic 4587559935 Practice locations: Ferriday, LA

National Provider Directory

Tax ID family
Concordia Parish HSD No 1 (5 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207Q00000X 247A LA
Rural Health Clinic/Center 261QR1300X Yes

Addresses

Primary practice location

204 Serio Blvd
Ferriday, LA 71334-2015

Mailing address

204 Serio Blvd
Ferriday, LA 71334
Phone (318) 757-0210

Other identifiers

IdentifierTypeStateIssuer
2518771MedicaidLA

Other names

  • TRINITY MEDICAL FERRIDAY CLINIC Doing business as

Other providers in Ferriday, LA

All providers in Ferriday, LA · Rural Health Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.