NPIMap

Organization Active NPI

Baton Rouge Specialty Hospital

  • Long Term Care Hospital
  • Baton Rouge, LA
National Provider Identifier
1912740994
Registry record updated Apr 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care HospitalTaxonomy code 282E00000X
Legal business name
BATON ROUGE SPECIALTY HOSPITAL
Practice address
5130 Mancuso LN
Baton Rouge, LA 70809-3583
Phone
(225) 490-9600
NPI assigned
Jun 17, 2024
Last updated
Apr 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2025

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

Authorized official

Name
Tammy Jean Thompson
Title
VP/Cfo
Phone
(209) 287-6308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Hospital 282E00000X NU Primary

Addresses

Primary practice location

5130 Mancuso LN
Baton Rouge, LA 70809-3583

Mailing address

700 17TH St Ste 205
Modesto, CA 95354-1249
Phone (209) 287-6308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240823002007 LA Part A Provider - Hospital 3072052935 Practice locations: Baton Rouge, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912740994. Details of each certification follow.

Hospital certification: CCN 192004

Legal name
BATON ROUGE SPECIALTY HOSPITAL
Doing business as
BATON ROUGE SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Long-term
Participating since
Sep 18, 1988
Last certification
Jun 1, 2024
Beds
54
Ownership / control type
Private (for profit)
Most recent change of ownership
May 19, 2024 (3 total)
Organization structure
CorporationProprietary
Enrollment address
5130 Mancuso LN
Baton Rouge, LA 70809-3583
Main/Primary Hospital Location
Hospital subgroups
Acute care, Long-term, Other

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Long-term care hospital

Medicare Care Compare
Listed as
Baton Rouge Specialty HospitalCCN 192004 · All quality measures
Ownership
For profit
Certified
Sep 18, 1988
Medicare certification status
ActiveFrom the Provider of Services file
Beds
54

National Provider Directory

National Provider Directory
Tax ID family
Baton Rouge Specialty Hospital2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gurpreet Singh Randhawa Individual 5% Or Greater Direct Ownership InterestChief Executive Officer May 19, 2024 100%
Baton Rouge Specialty Hospital Organization, Modesto, CA Created for acquisition, Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest May 19, 2024
Shamsher Bhullar Individual Operational/Managerial ControlSecretary May 19, 2024
Tammy Thompson Individual Corporate OfficerChief Financial Officer May 19, 2024
Operational/Managerial ControlChief Financial Officer May 19, 2024

Owners & managing parties with NPI records 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743465600000",
    "number": "1912740994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 17TH ST STE 205",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953541249",
            "telephone_number": "209-287-6308",
            "fax_number": "209-248-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 MANCUSO LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093583",
            "telephone_number": "225-490-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATON ROUGE SPECIALTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-17",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "209-287-6308"
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.