NPIMap

Organization Active NPI

CLHG-Avoyelles LLC

Doing business as Avoyelles Hospital Rural Health Clinic

  • Rural Health Clinic/Center
  • Marksville, LA
National Provider Identifier
1962924928
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CLHG-AVOYELLES LLC
Doing business as
Avoyelles Hospital Rural Health Clinic
Practice address
4239 Highway 1192 Ste 300
Marksville, LA 71351-4772
Phone
(318) 253-0677
Fax
(318) 253-0679
NPI assigned
Jul 12, 2017
Last updated
Oct 17, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
CLHG-AVOYELLES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Timothey Curry
Title
Ceo
Phone
(318) 240-6000

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary
Durable Medical Equipment & Medical Supplies 332B00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

4239 Highway 1192 Ste 300
Marksville, LA 71351-4772

Mailing address

PO Box 249
Marksville, LA 71351-0249
Phone (318) 253-0677

Other names 1

  • Avoyelles Hospital Rural Health Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20170808002421 LA Part A Provider - Rural Health Clinic 8921380528 Practice locations: Marksville, LA
O20180828001494 LA Part B Supplier - Clinic/Group Practice 8921380528 Receives reassigned benefits from 87 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marksville, LA; Moreauville, LA; Lecompte, LA; Hessmer, LA; Cottonport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962924928. Details of each certification follow.

Rural health clinic certification: CCN 198505

Legal name
CLHG-AVOYELLES LLC
Doing business as
AVOYELLES HOSPITAL RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 6, 2018
Last certification
Aug 6, 2021
Ownership / control type
For profit – corporation
Organization structure
LLCProprietary
Incorporated
Jul 27, 2017 in LA
Enrollment address
4239 Highway 1192
Ste 300
Marksville, LA 71351-4772
Related CCNs
190099

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

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
CLHG-Avoyelles LLC8 organizations share this tax ID, including this one
Part of
CLHG-Avoyelles LLC

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Donald Cameron Individual 5% Or Greater Indirect Ownership Interest Sep 1, 2016 30%
Corporate Officer Sep 1, 2016
Rock Bordelon Individual 5% Or Greater Direct Ownership InterestOwner Sep 1, 2016 65%
Allegiance Health Management Inc Organization, Bossier City, LA Corporation Operational/Managerial Control Mar 17, 2022
Timothey Curry Individual Corporate DirectorChief Executive Officer Jun 11, 2018
W-2 Managing EmployeeChief Executive Officer Jun 11, 2018
Operational/Managerial ControlCeo Jun 11, 2018 100%
Scott Markstrom Individual 5% Or Greater Direct Ownership InterestChief Financial Officer Sep 1, 2016 5%
Cameron Investments LLC Organization, Shreveport, LA 5% Or Greater Direct Ownership Interest Sep 1, 2016 30%

Facilities with the same owner 53

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

View all 53

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1962924928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713510249",
            "telephone_number": "318-253-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4239 HIGHWAY 1192 STE 300",
            "city": "MARKSVILLE",
            "state": "LA",
            "postal_code": "713514772",
            "telephone_number": "318-253-0677",
            "fax_number": "318-253-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-AVOYELLES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CLHG-AVOYELLES LLC",
        "enumeration_date": "2017-07-12",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "CURRY",
        "authorized_official_first_name": "TIMOTHEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-240-6000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avoyelles Hospital Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marksville, LA

Sources for this page

Verify at the official NPI Registry.