NPIMap

Organization Active NPI

Desoto Hospital Association

Doing business as Desoto Regional Health System Zwolle Rural Clinic

  • Rural Health Clinic/Center
  • Zwolle, LA
National Provider Identifier
1932246378
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
DESOTO HOSPITAL ASSOCIATION
Doing business as
Desoto Regional Health System Zwolle Rural Clinic
DRFM Zwolle Rural Clinic
Desoto Regional Health System1 more in Other names
Practice address
2026 Obrie Street
Zwolle, LA 71486-1339
Phone
(318) 645-6013
NPI assigned
Feb 1, 2007
Last updated
Dec 6, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
DESOTO HOSPITAL ASSOCIATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Christopher Davis
Title
Coo
Phone
(318) 270-3250

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

2026 Obrie Street
Zwolle, LA 71486-1339

Mailing address

2026 Obrie Street
PO Box 1339
Zwolle, LA 71486-1339
Phone (318) 645-6013

Other identifiers 2

IdentifierTypeStateIssuer
1447242MedicaidLA
193449OtherLAMEDICARE

Other names 4

  • DESOTO REGIONAL HEALTH SYSTEM ZWOLLE RURAL CLINIC Doing business as
  • DRFM Zwolle Rural Clinic Doing business as
  • Desoto Regional Health System Doing business as
  • Zwolle Rural Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000239 LA Part A Provider - Rural Health Clinic 7810898582 Practice locations: Zwolle, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932246378. Details of each certification follow.

Rural health clinic certification: CCN 193449

Legal name
DESOTO HOSPITAL ASSOCIATION
Doing business as
DESOTO REGIONAL HEALTH SYSTEM ZWOLLE RURAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 25, 2004
Last certification
Jun 19, 2023
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1949 in LA
Enrollment address
2026 Obrie St
Zwolle, LA 71486-3263
Related CCNs
190118

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

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
19D1018668Desoto Regional Health System2026 Obrie Steet, Zwolle, LA 71486ComplianceJun 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Desoto Hospital Associa6 organizations share this tax ID, including this one
Part of
Desoto Hospital Associa

Other organizations with this tax ID 5

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

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

Locations

2026 Obrie St
Zwolle, LA 71486
Phone (318) 645-6013

2036 Obrie St
Zwolle, LA 71486
Phone (318) 645-6013

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
Sandra Anderson Individual Corporate DirectorCfo May 13, 2013
W-2 Managing EmployeeCfo May 13, 2013
Desoto Hospital Association Organization, Mansfield, LA Corporation 5% Or Greater Direct Ownership Interest Mar 25, 2004 100%
Christopher Davis Individual Corporate Officer Nov 15, 2015
Larry T Eppler Individual Corporate OfficerCeo Jul 1, 2013
W-2 Managing EmployeeCeo Jul 1, 2013

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 3

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

FacilityTypeRoleSince
Desoto Regional Health SystemMansfield, LA, CCN 190118 Hospital Operational/Managerial Control Aug 28, 2012
Desoto Regional Health SystemMansfield, LA, CCN 19U118 Hospital Operational/Managerial Control Feb 28, 2022
Louisiana HomecareMansfield, LA, CCN 197052 Home health agency 5% Or Greater Direct Ownership Interest (33%) Sep 1, 2001

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.

Practitioners & affiliated clinicians

Practitioners 7

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1932246378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 OBRIE STREET",
            "address_2": "PO BOX 1339",
            "city": "ZWOLLE",
            "state": "LA",
            "postal_code": "714861339",
            "telephone_number": "318-645-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 OBRIE STREET",
            "city": "ZWOLLE",
            "state": "LA",
            "postal_code": "714861339",
            "telephone_number": "318-645-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO HOSPITAL ASSOCIATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DESOTO HOSPITAL ASSOCIATION",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-12-06",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-270-3250"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447242",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "193449",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DESOTO REGIONAL HEALTH SYSTEM ZWOLLE RURAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DRFM Zwolle Rural Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desoto Regional Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Desoto Regional Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Zwolle Rural Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zwolle, LA

Sources for this page

Verify at the official NPI Registry.