NPIMap

Organization Active NPI

West Jefferson Holdings, LLC

Doing business as West Jefferson Medical Center

  • Rehabilitation Hospital Unit
  • Marrero, LA
National Provider Identifier
1679631402
Registry record updated Apr 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
236 Issued in LA
Legal business name
WEST JEFFERSON HOLDINGS, LLC
Doing business as
West Jefferson Medical Center
Practice address
1101 Medical Center Blvd
Marrero, LA 70072-3147
Phone
(504) 349-1383
Fax
(504) 349-1334
NPI assigned
Dec 5, 2006
Last updated
Apr 7, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
WEST JEFFERSON HOLDINGS, LLSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2016

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

Authorized official

Name
Ms. Stacey Ballard
Title
Director Patient Business Services
Phone
(504) 349-1383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 236 LA Primary

Addresses

Primary practice location

1101 Medical Center Blvd
Marrero, LA 70072-3147

Mailing address

1101 Medical Center Blvd
Marrero, LA 70072-3147
Phone (504) 349-1383

Other names 1

  • West Jefferson Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160115000296 LA Part A Provider - Hospital 4981914934 Practice locations: Marrero, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679631402. Details of each certification follow.

Hospital certification: CCN 19T039

Legal name
WEST JEFFERSON HOLDINGS LLC
Doing business as
WEST JEFFERSON MEDICAL CENTER
Organization structure
LLCNon-profit
Enrollment address
1101 Medical Center Blvd
Marrero, LA 70072-3147
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

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

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
West Jefferson Medical CenterCCN 19T039 · All quality measures
Ownership
Non-profit
Certified
Jan 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
West Jefferson Holdings LLC6 organizations share this tax ID, including this one
Part of
West Jefferson Holdings LLC

Other organizations with this tax ID 5

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

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

175 Hector Ave
Ste 100
Gretna, LA 70056
Phone (504) 349-6925

515 Westbank Expy
Gretna, LA 70053
Phone (504) 366-7233

2845 Manhattan Blvd
Harvey, LA 70058
Phone (504) 349-6930

3909 Lapalco Blvd
Harvey, LA 70058
Phone (504) 349-6216

1101 Medical Center Blvd
Ste N105
Marrero, LA 70072
Phone (504) 349-6291

1111 Medical Center Blvd
Marrero, LA 70072
Phone (504) 349-2332

1111 Medical Center Blvd
Ste N304
Marrero, LA 70072
Phone (504) 349-6325

1111 Medical Center Blvd
Ste N707
Marrero, LA 70072
Phone (504) 934-8550

1111 Medical Center Blvd
Ste S150
Marrero, LA 70072
Phone (504) 348-1845

1111 Medical Center Blvd
Ste S640
Marrero, LA 70072
Phone (504) 349-2150

4500 10th St
Ste Ad
Marrero, LA 70072
Phone (504) 349-6222

4500 Wichers Dr
Marrero, LA 70072
Phone (504) 341-4986

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Louisiana Children's Medical Center Organization, New Orleans, LA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 2015 100%
Other Oct 1, 2015
Timothy P Kerner Individual Corporate DirectorBoard Member Oct 1, 2015
Frank C Divincenti Individual Corporate DirectorBoard Member Oct 1, 2015
Chad Miller Individual W-2 Managing Employee Feb 27, 2023
David F Andignac Individual Corporate DirectorBoard Member Oct 1, 2015
Rachel S Spears Individual Corporate Director Jan 1, 2021
Robert Calhoun Individual Corporate DirectorPresident & Ceo Jul 29, 2019
W-2 Managing EmployeePresident & Ceo Jul 29, 2019
William a Lazaro Individual Corporate DirectorBoard Member Oct 1, 2015
West Jefferson Holdings LLC Organization, Marrero, LA Created for acquisition, LLC, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2015 100%
Operational/Managerial Control Oct 1, 2015
Gregory C Feirn Individual Corporate OfficerCeo of Louisiana Children's Medi Oct 1, 2015
Corporate DirectorBoard Member Oct 1, 2015
Operational/Managerial ControlCfo Louisiana Children's Medical Oct 1, 2015
James E Cramond Individual Corporate DirectorBoard Member Oct 1, 2015
Blair Constant Individual Corporate Director Nov 19, 2021
Harry L Cahill Individual Corporate DirectorBoard Member Oct 1, 2015
Wesley W Bryan Individual Corporate Director Jan 1, 2023
Dwayne J Munch Individual Corporate DirectorBoard Member Oct 1, 2015

Owners & managing parties with NPI records 3

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
West Jefferson Medical CenterMarrero, LA, CCN 190039 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Oct 1, 2015
Oct 1, 2015

Owned or controlled facilities with NPI records 1

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

  • West Jefferson Holdings, LLC

    dba West Jefferson Medical Center

    • General Acute Care Hospital
    • Marrero, LA
    • NPI 1265437644

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Facilities with the same owner 12

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

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

Affiliated clinicians 4

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1679631402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-349-1383",
            "fax_number": "504-349-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL CENTER BLVD",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723147",
            "telephone_number": "504-349-1383",
            "fax_number": "504-349-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON HOLDINGS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST JEFFERSON HOLDINGS, LLS",
        "enumeration_date": "2006-12-05",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "DIRECTOR PATIENT BUSINESS SERVICES",
        "authorized_official_telephone_number": "504-349-1383",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "LA",
            "license": "236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Jefferson Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

Verify at the official NPI Registry.