NPIMap

Organization Active NPI

Hospital Service District 2 of the Parish of Tangipahoa State of la.

Doing business as Amite Rural Health Clinic

  • Rural Health Clinic/Center
  • Amite, LA
National Provider Identifier
1932246261
Registry record updated Sep 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
139-RHC2 Issued in LA
Legal business name
HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.
Doing business as
Amite Rural Health Clinic
Practice address
409 N W Central Ave
Amite, LA 70422-2025
Phone
(985) 748-7141
Fax
(985) 748-3181
NPI assigned
Jan 30, 2007
Last updated
Sep 1, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
HOSPITAL SERVICE DISTRICT 2 OF THE PARISIH OF TANGIPAHOA STATE OF LA.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 1, 2017

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

Authorized official

Name
Mr. Edward C. Dugar
Title
Ceo
Phone
(985) 284-2404

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X
Rural Health Clinic/Center 261QR1300X 139-RHC2 LA Primary

Addresses

Primary practice location

409 N W Central Ave
Amite, LA 70422-2025

Mailing address

409 N W Central Ave
Amite, LA 70422-2428
Phone (985) 748-9485

Other identifiers 1

IdentifierTypeStateIssuer
1943959MedicaidLA

Other names 1

  • Amite Rural Health Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100305000494 LA Part A Provider - Rural Health Clinic 2163314949 1 other NPI on this enrollment
Practice locations: Amite, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932246261. Details of each certification follow.

Rural health clinic certification: CCN 193985

Legal name
HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA
Doing business as
AMITE RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Sep 16, 1994
Last certification
Apr 17, 2026
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
409 NW Central Ave
Amite, LA 70422-2428
Related CCNs
191309

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

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0969592Amite Rural Health Clinic409 NW Central Avenue, Amite, LA 70422Certificate of waiverJan 19, 2028

National Provider Directory

National Provider Directory
Tax ID family
Hood Memorial Hospital3 organizations share this tax ID, including this one
Part of
Hood Memorial Hospital

Other organizations with this tax ID 2

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

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

409 NW Central Ave
Amite, LA 70422
Phone (985) 748-7141

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Hospital Service District 2 of the Parish of Tangipahoa State of la Organization, Amite, LA Non-profit Operational/Managerial Control Jun 16, 2014 50%
Randy Bracy Individual Corporate OfficerBoard Member Jan 1, 2018
Michael J Magee Individual Operational/Managerial ControlCfo Jul 25, 2018
Arthur a Mauterer Individual Corporate OfficerBoard Member Jan 1, 2012
Charles Guzzardo Individual Corporate OfficerBoard Member Aug 1, 2011
Raymond R Cutrer Individual Corporate OfficerBoard Member Jan 1, 2017
Robert W Lee Individual Corporate OfficerBoarad Member Jan 1, 2014

Owners & managing parties with NPI records 4

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Hood Memorial Hospital Swing BedAmite, LA, CCN 19Z309 Hospital 5% Or Greater Direct Ownership Interest Apr 1, 2003
West Oak Family ClinicAmite, LA, CCN 198558 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 28, 2025
Jul 28, 2025

Owned or controlled facilities with NPI records 3

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

Facilities with the same owner 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504224000000",
    "number": "1932246261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 N W CENTRAL AVE",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222428",
            "telephone_number": "985-748-9485",
            "fax_number": "985-748-8144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N W CENTRAL AVE",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222025",
            "telephone_number": "985-748-7141",
            "fax_number": "985-748-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HOSPITAL SERVICE DISTRICT 2 OF THE PARISIH OF TANGIPAHOA STATE OF LA.",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-09-01",
        "status": "A",
        "authorized_official_last_name": "DUGAR",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "985-284-2404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "LA",
            "license": "139-RHC2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1943959",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amite Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Amite, LA

Sources for this page

Verify at the official NPI Registry.