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Abbeville General Hospital

Organization Active NPI Rural Health Clinic/Center · Abbeville, LA

NPI 1790744506 · NPPES record last updated Nov 10, 2020

Key facts

NPI
1790744506
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
160 RHC-1 (LA)
Legal business name
ABBEVILLE GENERAL HOSPITAL
Practice address
2419 Alonzo St
Abbeville, LA 70510-4008
Phone
(337) 892-0630
Fax
(337) 893-0403
NPI assigned
Mar 21, 2006
Organization subpart
No

Authorized official

Name
Ray Landry
Title
Ceo
Phone
(337) 893-5466

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 6

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

Corporate family (same tax ID) 4

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

Member organizations 4

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

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

Practitioners 29

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

View all 29

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1002256Abbeville General Hospital Clinic
2419 Alonzo Street, Abbeville, LA 70510		Certificate of waiverAug 1, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Rural health clinic certification: CCN 193465

Legal name
ABBEVILLE GENERAL HOSPITAL
Doing business as
ABBEVILLE GENERAL HOSPITAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 20, 2005
Last certification
Jan 4, 2018
Ownership / control type
Non-profit – church related
Organization structure
Other · Non-profit
Enrollment address
2419 Alonzo St
Abbeville, LA 70510-4008
Related CCNs
190034

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Chuck E Guidry
Individual 		Corporate Officer
Cio		 Feb 22, 2022
Dondi Arceneaux
Individual 		Corporate Officer
Support Services Director		 Feb 22, 2022
Heidi C Broussard
Individual 		Corporate Officer
Cno		 Feb 22, 2022
Thomas Pigott
Individual 		Corporate Officer
Coo		 Feb 22, 2022
Brittany L Thibodeaux
Individual 		Corporate Officer
Cqo		 Feb 22, 2022
Michael Bertrand
Individual 		Corporate Officer
Ceo		 May 2, 2022
Corporate Director
Ceo		 May 2, 2022
William Troy Hair
Individual 		W-2 Managing Employee
Action Ceo		 Mar 6, 2015
Operational/Managerial Control Sep 15, 2013

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Erath-Delcambre Community Care Clinic
Erath, LA · CCN 193490		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1966

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051117001034 LA Part a Provider - Rural Health Clinic 8325933872 Practice locations: Abbeville, LA

National Provider Directory

Tax ID family
Abbeville General Hosp Phcy (5 organizations share this tax ID)

Locations

220 North Rd
Erath, LA 70533
Phone (337) 364-3301

Interoperability endpoints

  • Direct secure messaging: abbanitacrutchfield@abbgen.cernerdirect.com
  • Direct secure messaging: abbgilbertpellerin@abbgen.cernerdirect.com
  • Direct secure messaging: abbloreenkarani@abbgen.cernerdirect.com
  • Direct secure messaging: abbsethlandry@abbgen.cernerdirect.com
  • Direct secure messaging: abbmandyboudreaux@abbgen.cernerdirect.com
  • Direct secure messaging: abbcatherineboutte@abbgen.cernerdirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 160 RHC-1 LA Yes

Addresses

Primary practice location

2419 Alonzo St
Abbeville, LA 70510-4008

Mailing address

118 N Hospital Dr
Abbeville, LA 70510-4039
Phone (337) 893-5466

Other identifiers

IdentifierTypeStateIssuer
1448087MedicaidLA

Other names

  • Abbeville General Hospital Clinic Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address ABBSETHLANDRY@abbgen.cernerdirect.com Direct
Direct Messaging Address ABBCATHERINEBOUTTE@abbgen.cernerdirect.com Direct
Direct Messaging Address ABBGILBERTPELLERIN@abbgen.cernerdirect.com Direct
Direct Messaging Address ABBANITACRUTCHFIELD@abbgen.cernerdirect.com Direct
Direct Messaging Address ABBMANDYBOUDREAUX@abbgen.cernerdirect.com Direct
Direct Messaging Address ABBLOREENKARANI@abbgen.cernerdirect.com Direct

Other providers in Abbeville, LA

All providers in Abbeville, LA · Rural Health Clinic/Center in Louisiana

Sources for this page

Verify at the official NPI Registry.