Calcasieu Cameron Hospital Service District
Organization Active NPI Home Health Agency · Sulphur, LA
NPI 1831171503 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1831171503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Home Health Agency 251E00000X
- License
- 222 (LA)
- Legal business name
- CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
- Practice address
- 701 Cypress St
Sulphur, LA 70663 - Phone
- (337) 527-4362
- Fax
- (337) 527-4181
- NPI assigned
- Nov 17, 2005
- Organization subpart
- Yes
- Parent organization (as reported)
- CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
Authorized official
- Name
- Jobie James
- Title
- Cfo
- Phone
- (337) 527-4143
Owned or controlled facilities with NPI records 8
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 14
Practitioners 50
-
Cody Michael Abshire, CRNA
-
Yvonne Eileen Alexander, FNP-C
-
Yazan Ali Alqara, MD
-
Sami Leigh Babaz, N.P.
-
Louise M Becnel, MD
-
Scott Eric Bergstedt, M.D.
-
Joseph R. Caraway, CRNA
-
Kari L Cherp, APRN
-
Fidencio Hernan Davalos, M.D.
-
Corey G Foster, MD
-
Jason Brian Fuqua, M.D.
-
Kelly Marie Fuqua, M.D.
-
Jody Robert George, M.D.
-
Brett Jared Goodwin, M.D.
-
Jeremy Gormly, CRNA
-
Jadah Granger, APRN
-
Allison Johnson Hansen, CNM, APRN
-
Garett R Istre, N.P.
-
Alexis Elizabeth Juneau, APRN, FNP-C
-
Sandy F Leger, CRNA
Affiliated clinicians 17
-
Yvonne Eileen Alexander, FNP-C
-
Rebecca Braud, M.D.
-
Andrew T Davies, M.D.
-
Marne' Eve Devillier, M.D.
-
Jason Brian Fuqua, M.D.
-
Kelly Marie Fuqua, M.D.
-
Jody Robert George, M.D.
-
Garett R Istre, N.P.
-
Maureen Rose Lannan, M.D.
-
Derrick Thibodeaux, N.P.
-
Ken Thomas, M.D.
Medicare Care Compare: Home health agency
- Listed as
- West Calcasieu Cameron Hospital HHA
- Overall star rating
- ★★★★☆ 4 of 5
- Ownership
- Government Operated
- Certified
- Mar 28, 1985
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Home health agency certification: CCN 197178
- Legal name
- CALCASIEU CAMERON HOSPITAL SERVICE DISTRICT
- Doing business as
- WEST CALCASIEU CAMERON HOSPITAL HHA
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Mar 28, 1985
- Last certification
- May 24, 2019
- Ownership / control type
- Government Operated
- Organization structure
- Other · Non-profit
- Enrollment address
- 1327 Stelly Lane
Suite # 1
Sulphur, LA 70663-5650
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Anne M Broussard |
W-2 Managing Employee |
Jun 1, 2020 | 100% |
| Janie Fruge |
Corporate Officer |
Jul 1, 2013 | 100% |
| W-2 Managing Employee |
Jul 1, 2013 | 100% | |
| Operational/Managerial Control |
Jul 1, 2013 | 100% | |
| Jobie James |
Corporate Officer |
May 5, 2014 | 100% |
| W-2 Managing Employee |
May 5, 2014 | 100% | |
| Operational/Managerial Control |
May 5, 2014 | 100% |
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| West Calcasieu Cameron Hospital |
Hospital | Operational/Managerial Control (100%) | Mar 1, 2013 |
| Johnson Bayou Rural Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Nov 16, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050427000404 | LA | Part a Provider - Home Health Agency | 1052221447 | Practice locations: Sulphur, LA |
National Provider Directory
- Tax ID family
- West Calca Sieu Cameron
- Part of
- West Calca Sieu Cameron
Locations
3500 N Causeway Blvd
Ste 220
Metairie, LA 70002
Phone (504) 372-6610
1327 Stelly Ln
Ste 1
Sulphur, LA 70663
Phone (337) 527-4362
703 Cypress St
Ste A
Sulphur, LA 70663
Phone (337) 310-0395
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 222 | LA | Yes |
Addresses
Primary practice location
701 Cypress St
Sulphur, LA 70663
Mailing address
701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4362
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1401781 | Medicaid | LA |
Other names
- West Calcasieu Cameron Hospital Home Health Agency
Other providers in Sulphur, LA
- Calcasieu Cameron Hospital Service District
- Calcasieu Cameron Hospital Service District
- Calcasieu Cameron Hospital Service District
- Calcasieu Cameron Hospital Service District
- Calcasieu Cameron Hospital Service District
- Calcasieu Cameron Hospital Service District
- Calcasieu Family Physicians, Apmc
- Calcasieu Lung and Sleep LLC
- Calcasieu Multi-Handicapped Center, LLC
- Calcasieu Physicians Services LLC
All providers in Sulphur, LA · Home Health Agency in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.