NPIMap

Organization Active NPI

Sterlington Critical Access Hospital L.L.C

  • Medical Physician Assistant
  • Bastrop, LA
National Provider Identifier
1679935928
Registry record updated Dec 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2203781103 Issued in LA
Legal business name
STERLINGTON CRITICAL ACCESS HOSPITAL L.L.C
Practice address
370 W Hickory Ave
Bastrop, LA 71220-4442
Phone
(318) 281-4531
Fax
(318) 281-4534
NPI assigned
Mar 25, 2016
Organization subpart
Yes
Parent organization
STERLINGTON PART B PRACTICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 5, 2016

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

Authorized official

Name
Mrs. Laurie Doss
Title
Billing
Phone
(318) 665-9950

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363AM0700X 2203781103 LA Primary
Family Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LF0000X 2203781103 LA

Addresses

Primary practice location

370 W Hickory Ave
Bastrop, LA 71220-4442

Mailing address

PO Box 627
Sterlington, LA 71280-0627
Phone (318) 665-9950

Other identifiers 1

IdentifierTypeStateIssuer
1700495MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130520000548 LA Part B Supplier - Clinic/Group Practice 4486652385 Receives reassigned benefits from 15 practitioners
4 other NPIs on this enrollment
Practice locations: Bastrop, LA

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Sterlington Critical Access

Locations

370 W Hickory Ave
#B
Bastrop, LA 71220
Phone (318) 614-0592

Ownership & related parties

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Sterlington Rural Health ClinicSterlington, LA, CCN 193473 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 15, 2007
Sterlington Rehabilitation HospitalMer Rouge, LA, CCN 193486 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 1, 2008
Bastrop Outpatient Rural Health ClinicBastrop, LA, CCN 193484 Rural health clinic 5% Or Greater Direct Ownership Interest Mar 1, 2008

Owned or controlled facilities with NPI records 3

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

Practitioners & affiliated clinicians

Practitioners 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480896000000",
    "number": "1679935928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 627",
            "city": "STERLINGTON",
            "state": "LA",
            "postal_code": "712800627",
            "telephone_number": "318-665-9950",
            "fax_number": "318-665-9906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 W HICKORY AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204442",
            "telephone_number": "318-281-4531",
            "fax_number": "318-281-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STERLINGTON CRITICAL ACCESS HOSPITAL L.L.C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STERLINGTON PART B PRACTICE",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-12-05",
        "status": "A",
        "authorized_official_last_name": "DOSS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "318-665-9950",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "2203781103",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "2203781103",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700495",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

Verify at the official NPI Registry.