Active NPI
NW la War Veterans Home
- Skilled Nursing Facility
- Bossier City, LA
National Provider Identifier
1902955636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- NW LA WAR VETERANS HOME
- Practice address
- 3130 Arthur Ray Teague Parkway
Bossier City, LA 71112 - Phone
- (318) 741-2763
- NPI assigned
- Jan 10, 2007
- Organization subpart
- Yes
- Parent organization
- LOUISIANA DEPARTMENT OF VETERANS AFFAIRS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Byron Neal Hines
- Title
- Administrator
- Phone
- (318) 741-2763
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
3130 Arthur Ray Teague Parkway
Bossier City, LA 71112
Mailing address
3130 Arthur Ray Teague Parkway
Bossier City, LA 71112
Phone (318) 741-2763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070207000693 | LA | Part A Provider - Skilled Nursing Facility | 2567464381 | Practice locations: Bossier City, LA |
Skilled nursing facility certification: CCN 195623
- Legal name
- NW LA WAR VETERANS HOME
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF (Medicare) only
- Participating since
- May 8, 2007
- Last certification
- Jul 2, 2024
- Beds
- 156 (8 certified)
- Ownership / control type
- State
- Multi-facility organization
- Louisiana Department of Veteran Affairs
- Organization structure
- Other
- Enrollment address
- 3130 Arthur Ray Teague Parkway
Northwest la War Veteran's Home
Bossier City, LA 71112-2800 - Nursing home name
- NORTHWEST LOUISIANA VETERANS HOME
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Northwest Louisiana Veterans Home
- Overall star rating
- Health inspections
- Quality measures
- Type
- Medicare
- Ownership
- Government - State
- Certified
- May 8, 2007
- Medicare certification status
- Active
- Certified beds
- 8
National Provider Directory
National Provider Directory- Part of
- NW la War Veterans Home
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David Colvin | Contracted Managing Employee | Jan 1, 2021 | 4% |
| Adp of the SNF | Dec 26, 2024 | ||
| Wesley J Pepitone | W-2 Managing Employee | Aug 1, 2016 | 100% |
| Adp of the SNF | Dec 26, 2024 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Family Medicine Physician
- Shell Lake, WI
- NPI 1023010592
Adp of the SNF, Contracted Managing Employee
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1380758400000",
"number": "1902955636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3130 ARTHUR RAY TEAGUE PARKWAY",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "71112",
"telephone_number": "318-741-2763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3130 ARTHUR RAY TEAGUE PARKWAY",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "71112",
"telephone_number": "318-741-2763"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NW LA WAR VETERANS HOME",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LOUISIANA DEPARTMENT OF VETERANS AFFAIRS",
"enumeration_date": "2007-01-10",
"last_updated": "2013-10-03",
"status": "A",
"authorized_official_last_name": "HINES",
"authorized_official_first_name": "BYRON",
"authorized_official_middle_name": "NEAL",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "318-741-2763",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bossier City, LA
- Northwest Supports and Services Center
- Northwest Supports and Services Center
- Northwest Supports and Services Center
- Northwest Supports and Services Center
- Laurie L. Nussbaum, MSW, LCSW
- O'Neal Chiropractic Health Center
- Edmund Albert O'Neal, D. C.
- Latanya Andria Oats, RPH.
- Occupational Health Centers of Louisiana, a Professional Corp
- Karen Oconnor, LMFT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.