NPIMap

Organization Active NPI

Solutions Medical Consulting, LLC

Doing business as Serenity Springs Specialty Hospital

  • Psychiatric Hospital
  • Ruston, LA
National Provider Identifier
1720025919
Registry record updated Mar 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
SOLUTIONS MEDICAL CONSULTING, LLC
Doing business as
Serenity Springs Specialty Hospital
Practice address
1495 Frazier Rd
Ruston, LA 71270-1632
Phone
(318) 202-3860
Fax
(318) 202-5856
NPI assigned
May 31, 2006
Last updated
Mar 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2019

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

Authorized official

Name
Ms. Cindy Broadway
Title
Ceo
Phone
(318) 329-3933

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Psychiatric Hospital 283Q00000X Primary

Addresses

Primary practice location

1495 Frazier Rd
Ruston, LA 71270-1632

Mailing address

2404 Duval Dr
Monroe, LA 71201-2986
Phone (318) 322-3933

Other practice location 1

2100 Oliver Rd
Monroe, LA 71201-3628
Phone (318) 322-1134

Other practice location 2

2929 Highway 33
Ruston, LA 71270-1628
Phone (318) 251-9904

Other identifiers 1

IdentifierTypeStateIssuer
1704865MedicaidLA

Other names 1

  • Serenity Springs Specialty Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20121107000065 LA Part B Supplier - Clinic/Group Practice 6002944048 Receives reassigned benefits from 8 practitioners
Practice locations: Ruston, LA; Monroe, LA
O20130621000248 LA Part A Provider - Hospital 6002944048 Practice locations: Monroe, LA; Ruston, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720025919. Details of each certification follow.

Hospital certification: CCN 194074

Legal name
SOLUTIONS MEDICAL CONSULTING, LLC
Doing business as
SERENTY SPRINGS SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Mar 24, 2005
Last certification
Sep 28, 2022
Beds
24
Ownership / control type
Private (for profit)
Most recent change of ownership
Mar 8, 2010 (1 total)
Organization structure
LLCProprietary
Incorporated
Jul 1, 2004 in LA
Enrollment address
1495 Frazier Rd
Serenity Springs Specialty Hospital
Ruston, LA 71270-1628
Other Hospital Practice Location
Hospital subgroups
Psychiatric

Care Compare: Hospital

Medicare Care Compare
Listed as
Serenity Springs Specialty HospitalCCN 194074 · All quality measures
Type
Psychiatric
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Solutions Medical Consulting 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.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2929 Highway 33
Ruston, LA 71270
Phone (318) 251-9097

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Aruna Gullapalli Individual 5% Or Greater Direct Ownership Interest Mar 8, 2010 37.5%
Cynthia Broadway Individual Corporate OfficerBusiness Manager Jan 2, 2011
W-2 Managing Employee Jan 2, 2011
Kendall Corkern Individual 5% Or Greater Direct Ownership Interest Mar 8, 2010 25%
Adrian Williams Individual Corporate DirectorCeo Aug 1, 2012 100%
W-2 Managing EmployeeCeo Aug 1, 2012
Rambabu Gullapalli Individual 5% Or Greater Direct Ownership Interest Mar 8, 2010 37.5%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551916800000",
    "number": "1720025919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 DUVAL DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012986",
            "telephone_number": "318-322-3933",
            "fax_number": "318-322-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 FRAZIER RD",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712701632",
            "telephone_number": "318-202-3860",
            "fax_number": "318-202-5856"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Oliver Rd",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712013628",
            "country_code": "US",
            "telephone_number": "318-322-1134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2929 Highway 33",
            "address_purpose": "LOCATION",
            "city": "Ruston",
            "state": "LA",
            "postal_code": "712701628",
            "country_code": "US",
            "telephone_number": "318-251-9904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOLUTIONS MEDICAL CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2019-03-07",
        "status": "A",
        "authorized_official_last_name": "BROADWAY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-329-3933",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1704865",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Serenity Springs Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Serenity Springs Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.