Desoto Hospital Association
Organization Active NPI General Acute Care Hospital · Mansfield, LA
NPI 1679730667 · NPPES record last updated Nov 20, 2020
Key facts
- NPI
- 1679730667
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Acute Care Hospital 282N00000X
- Legal business name
- DESOTO HOSPITAL ASSOCIATION
- Practice address
- 207 Jefferson St
Mansfield, LA 71052-2603 - Phone
- (318) 872-4610
- Fax
- (318) 872-1502
- NPI assigned
- May 19, 2008
- Organization subpart
- No
Authorized official
- Name
- Christopher Davis
- Title
- VP of Finiance
- Phone
- (318) 872-2700
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 5
Practitioners 57
-
David Abdehou, MD
-
Larry David Allen Jr., APRN, PMHNP-BC
-
Katherine Latreas Brame, PA-C
-
Gary Von Burton, M.D.
-
Jason Patrick Calligas, M.D.
-
Jessica Caraway, MD
-
Anand M. Desai, MD
-
Lori Eubanks, FNP
-
Caleb Harkins, APRN, AGACNP
-
James E Harper, NP
-
Denis Kamberov, MD
-
CHI Tai Peter Lau, M.D.
-
Benjamin Leggio, MD
-
Jacqueline Loche, NP-C
-
Brenton Wayne McDonald, M.D.
-
Mikki Marie Olsson, LPC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040102000229 | LA | Part B Supplier - Clinic/Group Practice | 2163321829 |
Receives reassigned benefits from 56 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Mansfield, LA |
National Provider Directory
- Tax ID family
- Desoto Hospital Associa
Locations
2026 Obrie St
Zwolle, LA 71486
Phone (318) 645-6013
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hospitalist Physician |
208M00000X | |||
| General Acute Care Hospital | 282N00000X | 229 | LA | |
| General Acute Care Hospital | 282N00000X | Yes |
Addresses
Primary practice location
207 Jefferson St
Mansfield, LA 71052-2603
Mailing address
207 Jefferson St
Mansfield, LA 71052-2603
Phone (318) 872-4610
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04700 | Other | LA | BLUE CROSS |
| 1750131 | Medicaid | LA | |
| 1743283 | Medicaid | LA |
Other names
- DeSoto Regional Health System
Other providers in Mansfield, LA
- Desoto Healthcare Center Inc.
- Desoto Hospital Association
- Desoto Hospital Association
- Desoto Hospital Association
- Desoto Hospital Association
- Desoto Hospital Association
- Desoto Parish Ambulance Service District
- Desoto Parish Public School System
- Desoto Parish School Board
- Desoto Parish School Sytem
All providers in Mansfield, LA · General Acute 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 Nov 20, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.