Green Clinic Surgical Hospital, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

515 Issued in LA

Legal business name

GREEN CLINIC SURGICAL HOSPITAL, LLC

Practice address

1118 S Farmerville St
Ruston, LA 71270-5914

Phone

(318) 232-7700

Fax

(318) 232-1092

NPI assigned

Oct 12, 2006

Last updated

Jan 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James McClung

Title

Administrator

Phone

(318) 232-7186

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700975083. Details of each certification follow.

• CCN 190257 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 190257

Legal name

GREEN CLINIC SURGICAL HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Mar 1, 2015

Provider type (POS)

Hospital – Short-term

Participating since

Sep 29, 2003

Last certification

Oct 31, 2013

Beds

12

Ownership / control type

Physician ownership

Facility address

1118 Farmerville Street
Ruston, LA 71270

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Green Clinic LLC

  dba Quickcare of Ruston

  • Rural Health Clinic/Center
  • Ruston, LA
  • NPI 1578021093

  Member Of

  NPD member

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Green Clinic Surgical Hospital Crna Group

  • Certified Registered Nurse Anesthetist
  • Ruston, LA
  • NPI 1881877835
  NPPES parent name

Practitioners 2

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.

• Greene Butler, M.D.

  • Surgery Physician
  • Ruston, LA
  • NPI 1619947629
  NPD (past)
• Jacob Myles Wood, M.D.

  • Family Medicine Physician
  • Baton Rouge, LA
  • NPI 1700858255
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1700975083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705914",
            "telephone_number": "318-232-7700",
            "fax_number": "318-232-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705914",
            "telephone_number": "318-232-7700",
            "fax_number": "318-232-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CLINIC SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "MCCLUNG",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "318-232-7186",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Clinic LLC (Quickcare of Ruston)
• Green Clinic LLC
• Green Clinic LLC (Green Clinic Rehabilitation Services)
• Green Clinic Surgical Center
• Green Clinic Surgical Hospital Crna Group
• Brittany Green
• Janie Green
• Jena Paige Green
• Kelly Green, DPT
• Keeansia Greenwood

• General Acute Care Hospital in Ruston, LA
• Providers in Ruston, LA by specialty
• General Acute Care Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.