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Lafayette Physical Rehabilitation Hospital, LLC

Organization Active NPI Rehabilitation Hospital · Lafayette, LA

NPI 1881628097 · NPPES record last updated Jan 9, 2026

Key facts

NPI
1881628097
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Hospital 283X00000X
License
589 (LA)
Legal business name
LAFAYETTE PHYSICAL REHABILITATION HOSPITAL, LLC
Practice address
111 Republic Avenue
Lafayette, LA 70508
Phone
(337) 314-1111
Fax
(337) 314-1113
NPI assigned
Jul 11, 2006
Organization subpart
No

Authorized official

Name
Jessica Lane McGee
Title
Cfo
Phone
(337) 269-9566

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 1

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

Affiliated clinicians 7

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
Lafayette-Amg Physical Rehabilitation Hospital CCN 193093
Ownership
For profit
Certified
Feb 22, 2006
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

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
19D1053500Lafayette Physical Rehabilitation Hospital LLC
111 Republic Avenue, Lafayette, LA 70508		Certificate of waiverApr 25, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Hospital certification: CCN 193093

Legal name
LAFAYETTE PHYSICAL REHABILITATION HOSPITAL LLC
Doing business as
LAFAYETTE-AMG PHYSICAL REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Feb 22, 2006
Last certification
Nov 19, 2024
Beds
32
Ownership / control type
Private (for profit)
Organization structure
LLC · Proprietary
Incorporated
Aug 12, 2003 in LA
Enrollment address
111 Republic Avenue
Lafayette, LA 70508-6863
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

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
Amg 2 0 Holdco Inc
Organization · Lafayette, LA
Corporation 		5% Or Greater Indirect Ownership Interest Jan 2, 2022 100%
Timothy W Howard
Individual 		Corporate Officer
Corporate Ceo and Board Member		 Sep 1, 2003 100%
Jessica L McGee
Individual 		Corporate Officer
Chief Financial Officer		 Jan 1, 2013 10%
Abby H Aucoin
Individual 		W-2 Managing Employee
Ad;		 Feb 19, 2026 50%
Amg 2.0, LLC
Organization · Lafayette, LA
LLC 		5% Or Greater Direct Ownership Interest Jan 2, 2022 100%
August J Rantz
Individual 		Corporate Officer
President		 Jan 2, 2022 100%
Amg Employee Stock Ownership Plan
Organization · Lafayette, LA 		5% Or Greater Indirect Ownership Interest Jan 2, 2022 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20051129000981 LA Part a Provider - Hospital 6305866831 Practice locations: Lafayette, LA

National Provider Directory

Locations

307 Polly Ln
Lafayette, LA 70508
Phone (337) 314-1111

111 Republic Ave
Lafayette, LA 70508
Phone (337) 314-1111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X 589 LA Yes

Addresses

Primary practice location

111 Republic Avenue
Lafayette, LA 70508

Mailing address

101 La Rue France
Ste 500
Lafayette, LA 70508
Phone (337) 269-9566

Other identifiers

IdentifierTypeStateIssuer
61380OtherLABLUE CROSS BLUE SHIELD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 9, 2026.

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1881628097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LA RUE FRANCE",
            "address_2": "STE 500",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "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": "111 REPUBLIC AVENUE",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-314-1111",
            "fax_number": "337-314-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE PHYSICAL REHABILITATION HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "337-269-9566"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "LA",
            "license": "589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "61380",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

All providers in Lafayette, LA · Rehabilitation Hospital in Louisiana

Sources for this page

Verify at the official NPI Registry.