NPIMap

Organization Active NPI

Hospital Service District No 1 Parish of Avoyelles State of la

  • Rural Health Clinic/Center
  • Bunkie, LA
National Provider Identifier
1811942279
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
184RHC-1 Issued in LA
Legal business name
HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LA
Practice address
109 N Lexington Ave
Bunkie, LA 71322-1619
Phone
(318) 346-7283
NPI assigned
May 24, 2006
Last updated
Nov 9, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LOUISIANAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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

Authorized official

Name
Latrice Williams
Title
Business Office Manager
Phone
(318) 346-6681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 184RHC-1 LA Primary

Addresses

Primary practice location

109 N Lexington Ave
Bunkie, LA 71322-1619

Mailing address

PO Box 380
Bunkie, LA 71322-0380
Phone (318) 346-7283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031212000761 LA Part B Supplier - Clinic/Group Practice 3375440910 Receives reassigned benefits from 43 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bunkie, LA; Marksville, LA
O20100618000760 AR Part A Provider - Rural Health Clinic 3375440910 Practice locations: Bunkie, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811942279. Details of each certification follow.

Rural health clinic certification: CCN 193987

Legal name
HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LA
Doing business as
BUNKIE GENERAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 1, 1994
Last certification
Sep 27, 2021
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
109 N. Lexington Ave
Bunkie Rural Health Clinic
Bunkie, LA 71322-0380
Related CCNs
191311

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
19D0887696Bunkie General Hospital Rural Health109 North Lexington, Bunkie, LA 71322Certificate of waiverDec 10, 2027

National Provider Directory

National Provider Directory
Tax ID family
Hospital Service District No 1 Parish of Avoyelles State of Louisiana8 organizations share this tax ID, including this one
Part of
Hospital Service District No 1 Parish of Avoyelles State of Louisiana

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Linda Deville Individual Corporate Officer May 7, 2007
W-2 Managing EmployeeCeo Dec 8, 2016

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Bunkie General HospitalBunkie, LA, CCN 191311 Hospital Operational/Managerial Control (100%) May 7, 2007
Bunkie HomecareBunkie, LA, CCN 197114 Home health agency 5% Or Greater Direct Ownership Interest (33%) Mar 1, 2004

Owned or controlled facilities with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 9

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510185600000",
    "number": "1811942279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 380",
            "city": "BUNKIE",
            "state": "LA",
            "postal_code": "713220380",
            "telephone_number": "318-346-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N LEXINGTON AVE",
            "city": "BUNKIE",
            "state": "LA",
            "postal_code": "713221619",
            "telephone_number": "318-346-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL SERVICE DISTRICT NO 1 PARISH OF AVOYELLES STATE OF LOUISIANA",
        "enumeration_date": "2006-05-24",
        "last_updated": "2017-11-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LATRICE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "318-346-6681"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "184RHC-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bunkie, LA

Sources for this page

Verify at the official NPI Registry.