Lafayette Heart Hospital LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

393491 Issued in LA

Legal business name

LAFAYETTE HEART HOSPITAL LLC

Practice address

1105 Kaliste Saloom Rd
Lafayette, LA 70508-5705

Phone

(337) 521-1017

Fax

(337) 521-1320

NPI assigned

Jul 14, 2006

Last updated

Oct 9, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Donald J Fentem

Title

Director Business Office Operations

Phone

(972) 702-7500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902822786. Details of each certification follow.

• CCN 190263 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 190263

Legal name

HEART HOSPITAL OF LAFAYETTE

Certification status

Terminated Voluntary: merger or closure, Jan 1, 2020

Provider type (POS)

Hospital – Short-term

Participating since

Mar 26, 2004

Last certification

Oct 20, 2018

Beds

32

Ownership / control type

Private (for profit)

Most recent change of ownership

Dec 1, 2007 (1 total)

Facility address

1105 Kaliste Saloom Road
Lafayette, LA 70508

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191888000000",
    "number": "1902822786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "TX",
            "postal_code": "70508",
            "telephone_number": "337-521-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085705",
            "telephone_number": "337-521-1017",
            "fax_number": "337-521-1320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE HEART HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-10-09",
        "status": "A",
        "authorized_official_last_name": "FENTEM",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR BUSINESS OFFICE OPERATIONS",
        "authorized_official_telephone_number": "972-702-7500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "LA",
            "license": "393491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "60709",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1703095",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lafayette Health Ventures, Inc. (Hospitalist Services)
• Lafayette Health Ventures. Inc (OB-GYN Clinic)
• Lafayette Heart Clinic, LLC
• Lafayette Integrative Medicine LLC
• Lafayette Intensive Outpatient, LLC
• Lafayette Internal Medicine Clinic LLC
• Lafayette la Opco LLC (Maison de Lafayette of LA)
• Lafayette OB Hospitalists LLC (Lafayette OB Hospitalists)

• General Acute Care Hospital in Lafayette, LA
• Providers in Lafayette, LA by specialty
• General Acute Care Hospital in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.