Covington -Amg Specialty Hospital, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

526 Issued in LA

Legal business name

COVINGTON -AMG SPECIALTY HOSPITAL, LLC

Practice address

195 Highland Park Entrance
Covington, LA 70433-7164

Phone

(985) 867-3977

Fax

(985) 867-3979

NPI assigned

Aug 12, 2005

Organization subpart

No

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

Authorized official

Name

Mr. August Rantz IV

Title

President

Phone

(337) 269-9566

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 190262

Legal name

REGENCY HOSPITAL OF COVINGTON

Certification status

Terminated Other: provider status change, Oct 31, 2004

Provider type (POS)

Hospital – Short-term

Participating since

Apr 28, 2004

Last certification

Apr 28, 2004

Beds

38

Ownership / control type

Private (for profit)

Facility address

195 Highland Paul Entrance
Covington, LA 70433

Hospital certification: CCN 192051

Legal name

COVINGTON - A M G SPECIALTY HOSPITAL

Certification status

Terminated Voluntary: merger or closure, Oct 12, 2016

Provider type (POS)

Hospital – Long-term

Participating since

Nov 1, 2004

Last certification

Nov 19, 2015

Beds

38

Ownership / control type

Private (for profit)

Facility address

195 Highland Park Entrance
Covington, LA 70433

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447027200000",
    "number": "1851393458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LA RUE FRANCE STE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083138",
            "telephone_number": "337-269-9566",
            "fax_number": "337-234-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 HIGHLAND PARK ENTRANCE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337164",
            "telephone_number": "985-867-3977",
            "fax_number": "985-867-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON -AMG SPECIALTY HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2015-11-09",
        "status": "A",
        "authorized_official_last_name": "RANTZ",
        "authorized_official_first_name": "AUGUST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-269-9566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "LA",
            "license": "526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1701963",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTN",
            "identifier": "5CW01",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Providers in Covington, LA by specialty
• Long Term Care Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.