NPIMap

Organization Active NPI

Springhill Medical Services, Inc.

Doing business as North Webster Medical Clinic

  • Rural Health Clinic/Center
  • Sarepta, LA
National Provider Identifier
1932173564
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
441 RHC 3 Issued in LA
Legal business name
SPRINGHILL MEDICAL SERVICES, INC.
Doing business as
North Webster Medical Clinic
Practice address
106 Tri-State Drive
Sarepta, LA 71071-2826
Phone
(318) 994-2266
Fax
(318) 539-9177
NPI assigned
Feb 13, 2006
Last updated
May 19, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRINGHILL MEDICAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Authorized official

Name
Michael G Patronis
Title
Chief Executive Officer
Phone
(318) 539-1001

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Rural Health Clinic/Center 261QR1300X 441 RHC 3 LA Primary
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

106 Tri-State Drive
Sarepta, LA 71071-2826

Mailing address

106 Tri-State Drive
Sarepta, LA 71071
Phone (318) 994-2266

Other identifiers 3

IdentifierTypeStateIssuer
1441601MedicaidLA
159138002MedicaidAR
2165569MedicaidLA

Other names 1

  • North Webster Medical Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080616000489 LA Part A Provider - Rural Health Clinic 6002728912 Practice locations: Sarepta, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932173564. Details of each certification follow.

Rural health clinic certification: CCN 193482

Legal name
SPRINGHILL MEDICAL SERVICES, INC.
Doing business as
NORTH WEBSTER MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2010
Last certification
Apr 4, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Jul 17, 2000 in LA
Enrollment address
106 Tri State Drive
Sarepta, LA 71071-2826
Related CCNs
190088

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory
Tax ID family
Springhill Medical Services4 organizations share this tax ID, including this one
Part of
Springhill Medical Services

Other organizations with this tax ID 3

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

Locations

106 Tri State Dr
Sarepta, LA 71071
Phone (318) 994-2266

Ownership & related parties

All disclosed owners & managing parties 15

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

NameRoleSinceShare
Robert N Smith Individual Corporate Director Aug 1, 2021 9.09%
Jerry Sessions Individual Corporate Director Jan 1, 2017 9.09%
Peter B Johnson Individual Corporate OfficerChief Executive Officer Oct 9, 2021 50%
Operational/Managerial ControlChief Executive Officer Oct 9, 2021 50%
Robert Bush Individual Corporate Director May 29, 2008 9.09%
Robert Colvin Individual Corporate Director May 29, 2008 9.09%
Springhill Medical Services, Inc. Organization, Springhill, LA Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 2010 100%
Royce W McMahen Individual Corporate Director May 29, 2008 9.09%
David K Anderson Individual Corporate Director Jan 1, 2012 9.09%
William R Huddleston Individual Corporate Director Jan 1, 2017 9.09%
Elizabeth L Stephens Individual Corporate Director Aug 1, 2010 9.09%
Willie Lynd Individual Corporate Director Jan 1, 2017 9.09%
Mary D Armwood Individual Corporate Director Jan 1, 2012 9.09%
Kristin Cole Individual Corporate OfficerChief Nursing Officer Feb 1, 2019 25%
Operational/Managerial ControlChief Nursing Officer Feb 1, 2019 25%
Patricia a McMurray Individual Corporate Director Jan 1, 2017 9.09%
Brian a Griffin Individual Corporate OfficerChief Financial Officer Jan 31, 2022 25%
Operational/Managerial ControlChief Financial Officer Jan 31, 2022 25%

Owners & managing parties with NPI records 6

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

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Springhill Medical CenterSpringhill, LA, CCN 190088 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 17, 2000
Springhill Medical CenterSpringhill, LA, CCN 19U088 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 17, 2000
Springhill Medical CenterSpringhill, LA, CCN 19S088 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 17, 2000
Louisiana Homecare / SpringhillSpringhill, LA, CCN 197776 Home health agency 5% Or Greater Direct Ownership Interest (33%) Oct 1, 2018
SMC Doctors ClinicSpringhill, LA, CCN 193466 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Nov 17, 2000

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1932173564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 TRI-STATE DRIVE",
            "city": "SAREPTA",
            "state": "LA",
            "postal_code": "71071",
            "telephone_number": "318-994-2266",
            "fax_number": "318-539-9177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 TRI-STATE DRIVE",
            "city": "SAREPTA",
            "state": "LA",
            "postal_code": "710712826",
            "telephone_number": "318-994-2266",
            "fax_number": "318-539-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGHILL MEDICAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGHILL MEDICAL SERVICES, INC.",
        "enumeration_date": "2006-02-13",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "PATRONIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "318-539-1001"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "441 RHC 3",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1441601",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159138002",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165569",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Webster Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Webster Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarepta, LA

Sources for this page

Verify at the official NPI Registry.