NPIMap

Organization Active NPI

Homer Memorial Hospital

  • Rural Health Clinic/Center
  • Homer, LA
National Provider Identifier
1699340794
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HOMER MEMORIAL HOSPITAL
Practice address
912 W Main St
Homer, LA 71040-3328
Phone
(318) 927-3571
Fax
(318) 927-2677
NPI assigned
May 21, 2021
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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

Authorized official

Name
Anna Lee Jones
Title
Cqio
Phone
(318) 927-2024

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

912 W Main St
Homer, LA 71040-3328

Mailing address

620 E College St
Homer, LA 71040-3202
Phone (318) 927-2024

Other names 1

  • Claiborne Family Medical Clinic Other name

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL www.claibornemedical.com
CONNECT URL www.claibornemedical.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529001237 LA Part A Provider - Rural Health Clinic 1456322692 Practice locations: Homer, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699340794. Details of each certification follow.

Rural health clinic certification: CCN 198552

Legal name
HOMER MEMORIAL HOSPITAL
Doing business as
CLAIBORNE FAMILY MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 19, 2024
Last certification
Dec 19, 2024
Ownership / control type
Non-profit – church related
Organization structure
GovernmentProprietary
Enrollment address
912 W Main St
Homer, LA 71040-3328
Related CCNs
190114

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

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Homer Memorial Hosp Beh13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Michael W Fontenot Individual W-2 Managing EmployeeCfo Apr 2, 2024
Anna Lee Jones Individual W-2 Managing EmployeeCno Jan 1, 2021
Tina Haynes Individual Corporate OfficerCeo Dec 1, 2019

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Homer Medical ClinicHomer, LA, CCN 198507 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 30, 2015

Owned or controlled facilities with NPI records 1

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

NPI Registry JSON

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1699340794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 E COLLEGE ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403202",
            "telephone_number": "318-927-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 W MAIN ST",
            "city": "HOMER",
            "state": "LA",
            "postal_code": "710403328",
            "telephone_number": "318-927-3571",
            "fax_number": "318-927-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMER MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-21",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CQIO",
        "authorized_official_telephone_number": "318-927-2024"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.claibornemedical.com",
            "affiliation": "N",
            "address_1": "912 W Main St",
            "city": "Homer",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710403328",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.claibornemedical.com",
            "affiliation": "N",
            "address_1": "912 W Main St",
            "city": "Homer",
            "state": "LA",
            "country_code": "US",
            "postal_code": "710403328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Claiborne Family Medical Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Claiborne Family Medical Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Homer, LA

Sources for this page

Verify at the official NPI Registry.