NPIMap

Organization Active NPI

Abbeville General Hospital

Doing business as Abbeville General Hospital Clinic

  • Rural Health Clinic/Center
  • Abbeville, LA
National Provider Identifier
1790744506
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
160 RHC-1 Issued in LA
Legal business name
ABBEVILLE GENERAL HOSPITAL
Doing business as
Abbeville General Hospital Clinic
Practice address
2419 Alonzo St
Abbeville, LA 70510-4008
Phone
(337) 892-0630
Fax
(337) 893-0403
NPI assigned
Mar 21, 2006
Last updated
Nov 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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

Authorized official

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

Specialties & licenses 1

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

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 1

IdentifierTypeStateIssuer
1448087MedicaidLA

Other names 1

  • Abbeville General Hospital Clinic Doing business as

Electronic endpoints 6

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

Medicare participation

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

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790744506. Details of each certification follow.

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
OtherNon-profit
Enrollment address
2419 Alonzo St
Abbeville, LA 70510-4008
Related CCNs
190034

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).

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1002256Abbeville General Hospital Clinic2419 Alonzo Street, Abbeville, LA 70510Certificate of waiverAug 1, 2026

National Provider Directory

National Provider Directory
Tax ID family
Abbeville General Hospi5 organizations share this tax ID, including this one

Other organizations with this 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.

Interoperability endpoints

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

Ownership & related parties

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 OfficerCio Feb 22, 2022
Dondi Arceneaux Individual Corporate OfficerSupport Services Director Feb 22, 2022
Heidi C Broussard Individual Corporate OfficerCno Feb 22, 2022
Thomas Pigott Individual Corporate OfficerCoo Feb 22, 2022
Brittany L Thibodeaux Individual Corporate OfficerCqo Feb 22, 2022
Michael Bertrand Individual Corporate OfficerCeo May 2, 2022
Corporate DirectorCeo May 2, 2022
William Troy Hair Individual W-2 Managing EmployeeAction 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 ClinicErath, LA, CCN 193490 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Feb 1, 1966

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604966400000",
    "number": "1790744506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 N HOSPITAL DR",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705104039",
            "telephone_number": "337-893-5466",
            "fax_number": "337-893-2801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 ALONZO ST",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705104008",
            "telephone_number": "337-892-0630",
            "fax_number": "337-893-0403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBEVILLE GENERAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A",
        "authorized_official_last_name": "LANDRY",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-893-5466"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "160 RHC-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448087",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBSETHLANDRY@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General Hospital Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBCATHERINEBOUTTE@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General Hospital Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBGILBERTPELLERIN@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General- Women's Health of Vermilion Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBANITACRUTCHFIELD@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General- Women's Health of Vermilion Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBMANDYBOUDREAUX@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General- Women's Health of Vermilion Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ABBLOREENKARANI@abbgen.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Abbeville General- Pediatric Care Clinic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "2419 Alonzo St",
            "city": "Abbeville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705104008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Abbeville General Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Abbeville General Hospital Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Abbeville, LA

Sources for this page

Verify at the official NPI Registry.