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Organization Active NPI

Rehabilitation Hospital of Leesville LLC

  • Rehabilitation Hospital
  • Leesville, LA
National Provider Identifier
1992124697
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
Legal business name
REHABILITATION HOSPITAL OF LEESVILLE LLC
Practice address
900 S 6TH St
Leesville, LA 71446-4723
Phone
(337) 392-8118
Fax
(337) 392-8415
NPI assigned
Apr 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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

Authorized official

Name
Kristi Duncan
Title
Cfo
Phone
(505) 317-3802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X Primary

Addresses

Primary practice location

900 S 6TH St
Leesville, LA 71446-4723

Mailing address

5600 Wyoming Blvd NE Ste 225
Albuquerque, NM 87109-3136
Phone (505) 317-3802

Other identifiers 1

IdentifierTypeStateIssuer
1702951MedicaidLA

Other names 1

  • ClearSky Rehabilitation Hospital of Leesville Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141001001383 LA Part A Provider - Hospital 1951521681 Practice locations: Leesville, LA

Hospital certification: CCN 193086

Legal name
REHABILITATION HOSPITAL OF LEESVILLE, LLC
Doing business as
LEESVILLE REHABILITATION HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Sep 25, 2003
Last certification
Aug 11, 2022
Beds
16
Ownership / control type
Private (for profit)
Most recent change of ownership
May 1, 2014 (1 total)
Organization structure
LLCProprietary
Enrollment address
900 S 6TH St
Leesville, LA 71446-4723
Main/Primary Hospital Location
Hospital subgroups
Rehabilitation

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Leesville Rehabilitation HospitalCCN 193086
Ownership
For profit
Certified
Sep 25, 2003
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Rehabilitation Hospital of Leesville LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

2801 Network Blvd
Ste 810
Frisco, TX 75034

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Charles L Matthews Individual 5% Or Greater Indirect Ownership Interest Oct 1, 2024 100%
Corporate Officer Oct 1, 2024 100%
Corporate Director Oct 1, 2024 100%
Operational/Managerial Control Oct 1, 2024 100%
Titan Rehabilitation Institute of America, LLC Organization, Lafayette, LA LLC, For-profit, Chain home office 5% Or Greater Indirect Ownership Interest Oct 1, 2024 100%
Operational/Managerial Control Oct 1, 2024 100%

Facilities with the same owner 1

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.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1992124697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 WYOMING BLVD NE STE 225",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093136",
            "telephone_number": "505-317-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S 6TH ST",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714464723",
            "telephone_number": "337-392-8118",
            "fax_number": "337-392-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION HOSPITAL OF LEESVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "505-317-3802"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1702951",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ClearSky Rehabilitation Hospital of Leesville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesville, LA

Sources for this page

Verify at the official NPI Registry.