Natchitoches Nursing and Rehabilitation Center, LLC
Organization Active NPI Skilled Nursing Facility · Natchitoches, LA
NPI 1881769883 · NPPES record last updated Dec 11, 2023
Key facts
- NPI
- 1881769883
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 902 (LA)
- Legal business name
- NATCHITOCHES NURSING AND REHABILITATION CENTER, LLC
- Practice address
- 750 Keyser Ave
Natchitoches, LA 71457-6043 - Phone
- (318) 352-8779
- Fax
- (318) 352-8910
- NPI assigned
- Nov 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Norbert A Bennett
- Title
- Co-Chief Executive Officer
- Phone
- (716) 662-4955
Facilities with the same owner 30
Practitioners 1
-
David Juston Colvin, M.D.
Medicare Care Compare: Nursing home
- Listed as
- Natchitoches Nursing and Rehabilitation Center, LL
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★☆☆☆☆ 1 of 5
- Staffing
- ★☆☆☆☆ 1 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1994
- Medicare certification status
- Active
- Certified beds
- 98 · 64.4 residents per day on average
- Penalties (3 years)
- 4 · fines totaling $616,611
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195293
- Legal name
- NATCHITOCHES NURSING AND REHABILITATION CENTER, LLC
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jul 1, 1994
- Last certification
- Mar 12, 2025
- Beds
- 98
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC · Proprietary
- Incorporated
- Nov 1, 2005 in LA
- Enrollment address
- 750 Keyser Ave
Natchitoches, LA 71457-6043
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| D & N LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2005 | 50% |
| Donald T Denz Irrv TR |
5% Or Greater Indirect Ownership Interest | May 23, 2008 | 6% |
| Norbert a Bennett |
5% Or Greater Indirect Ownership Interest | Nov 1, 2005 | 32.45% |
| Donald T Denz |
5% Or Greater Indirect Ownership Interest | Nov 1, 2005 | 44% |
| Norbert a Bennett Irrv TR Fbo Grandchildren |
5% Or Greater Indirect Ownership Interest | May 23, 2008 | 17.55% |
| Norbert a Bennett Irrv TR Fbo Children |
5% Or Greater Indirect Ownership Interest | May 23, 2008 | 17.55% |
| Renee Klawon |
Other |
Aug 14, 2020 | |
| Cheyanne Clark |
W-2 Managing Employee |
May 10, 2021 | 100% |
| DTD HC LLC |
5% Or Greater Direct Ownership Interest | Nov 1, 2005 | 50% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051012000255 | LA | Part a Provider - Skilled Nursing Facility | 0547285256 | Practice locations: Natchitoches, LA |
National Provider Directory
Locations
750 Keyser Ave
Natchitoches, LA 71457
Phone (318) 352-8779
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 902 | LA | Yes |
Addresses
Primary practice location
750 Keyser Ave
Natchitoches, LA 71457-6043
Mailing address
PO Box 428
Orchard Park, NY 14127-0428
Phone (716) 662-4955
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1522180 | Medicaid | LA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | ENDPOINT | Other | The White Stone Group d/b/a Vyne Medical |
Other providers in Natchitoches, LA
- Natchitoches Behavioral Health Clinic
- Natchitoches Family Eye Care LLC
- Natchitoches Home Health Services, Inc.
- Natchitoches Medical Specialists
- Natchitoches Nephrology and Hypertension LLC
- Natchitoches Outpatient Services
- Natchitoches Parish Hospital Service District
- Natchitoches Parish Hospital Service District
- Natchitoches Parish Hospital Service District
- Natchitoches Parish Hospital Service District
All providers in Natchitoches, LA · Skilled Nursing Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2023. 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.