NPIMap

Organization Active NPI

Sage LTAC LLC

  • Long Term Care Hospital
  • Denham Springs, LA
National Provider Identifier
1700302197
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
SAGE LTAC LLC
Practice address
8375 Florida Blvd
Denham Springs, LA 70726-7806
Phone
(225) 665-2664
NPI assigned
Aug 17, 2017
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Geoffrey Morthland
Title
General Counsel
Phone
(225) 368-3181

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X NU
Long Term Care Hospital 282E00000X NU Primary

Addresses

Primary practice location

8375 Florida Blvd
Denham Springs, LA 70726-7806

Mailing address

10615 Jefferson Hwy
Baton Rouge, LA 70809-7230
Phone (225) 368-3181

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170914002629 LA Part A Provider - Hospital 3274807219 Practice locations: Baton Rouge, LA; Denham Springs, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700302197. Details of each certification follow.

Hospital certification: CCN 192008

Legal name
SAGE LTAC LLC
Doing business as
SAGE SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Jan 1, 1993
Last certification
Aug 16, 2023
Beds
93
Ownership / control type
Private (for profit)
Most recent change of ownership
Aug 31, 2017 (4 total)
Organization structure
LLCProprietary
Enrollment address
8375 Florida Blvd
Denham Springs, LA 70726-7806
Main/Primary Hospital Location
Hospital subgroups
Long-term

Other NPIs with the same Medicare PAC ID 1

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

  • Sage LTAC LLC

    dba Sage Specialty Hospital

    • Psychiatric Hospital Unit
    • Denham Springs, LA
    • NPI 1720601586

    3274807219

    Same PAC ID

Care Compare: Hospital

Medicare Care Compare
Listed as
Sage Specialty HospitalCCN 192008 · All quality measures
Type
Long-term
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Sage Specialty HospitalCCN 192008 · All quality measures
Ownership
For profit
Certified
Jan 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Beds
93

National Provider Directory

National Provider Directory
Tax ID family
Sage LTAC LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
PCM Rehab Enterprises LLC Organization, Baton Rouge, LA Created for acquisition, LLC 5% Or Greater Direct Ownership Interest May 1, 2019 100%
Patrick Thomas Mitchell Individual Operational/Managerial ControlManager/Ceo Aug 17, 2017 100%
OtherManager/Ceo May 1, 2019 1%
Sybil Chatman Miles Individual W-2 Managing EmployeeAd; Dec 31, 2021
Kelly Mitchell Individual Other Dec 31, 2022
PCM Intermediate Holdings LLC Organization, Baton Rouge, LA LLC, Holding company 5% Or Greater Indirect Ownership Interest Jul 18, 2025 100%
PTM 2018 Family Trust Organization, Baton Rouge, LA Created for acquisition 5% Or Greater Indirect Ownership Interest Dec 31, 2022 99%
Emily Holleman Individual Other Dec 31, 2022
PCM Holdings I, Inc. Organization, Baton Rouge, LA Corporation, Holding company 5% Or Greater Indirect Ownership Interest Jul 18, 2025 100%

Facilities with the same owner 35

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

View all 35

Practitioners & affiliated clinicians

Practitioners 5

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.

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": "1502928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1700302197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10615 JEFFERSON HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708097230",
            "telephone_number": "225-368-3181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8375 FLORIDA BLVD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707267806",
            "telephone_number": "225-665-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGE LTAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-17",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MORTHLAND",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "225-368-3181"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denham Springs, LA

Sources for this page

Verify at the official NPI Registry.