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Lallie Kemp Medical Ctr

Organization Active NPI Critical Access Hospital · Independence, LA

NPI 1972545846 · NPPES record last updated Apr 24, 2008

Key facts

NPI
1972545846
Entity type
Organization (NPI type 2)
Primary specialty
Critical Access Hospital 282NC0060X
Legal business name
LALLIE KEMP MEDICAL CTR
Practice address
52579 Highway 51 S
Independence, LA 70443-2231
Phone
(985) 878-9421
Fax
(985) 878-1263
NPI assigned
Jun 12, 2006
Organization subpart
No

Authorized official

Name
Dr. Michael K. Butler, M.D.
Title
Acting Ceo
Phone
(225) 922-0775

Other NPIs with the same Medicare PAC ID 2

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

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

Facilities with the same owner 1

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

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 105

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Hospital certification: CCN 19Z321

Legal name
LALLIE KEMP MEDICAL CTR
Organization structure
Government · Proprietary
Enrollment address
52579 Highway 51 S
Independence, LA 70443-2231
Hospital Swing-Bed Unit

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
Louisiana State University Health Sciences Center - Health Care Servic
Organization · Baton Rouge, LA
Corporation 		Operational/Managerial Control Jul 16, 2007
Michael Carter
Individual 		W-2 Managing Employee Sep 21, 2007
Chad Thompson
Individual 		W-2 Managing Employee Sep 21, 2007
Sherre Pack-Hookfin
Individual 		W-2 Managing Employee Sep 21, 2007

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220806000589 LA Part a Provider - Critical Access Hospital 0345238903 Practice locations: Independence, LA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X Yes

Addresses

Primary practice location

52579 Highway 51 S
Independence, LA 70443-2231

Mailing address

52579 Highway 51 S
Independence, LA 70443-2231
Phone (985) 878-9421

Other names

  • Lallie Kemp Regional Medical Center Doing business as

Other providers in Independence, LA

All providers in Independence, LA · Critical Access Hospital in Louisiana

Sources for this page

Verify at the official NPI Registry.