NPIMap

Organization Active NPI

Morehouse General Hospital

Doing business as Morehouse Family Medicine Rural Health Clinic

  • Rural Health Clinic/Center
  • Bastrop, LA
National Provider Identifier
1992207294
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MOREHOUSE GENERAL HOSPITAL
Doing business as
Morehouse Family Medicine Rural Health Clinic
Practice address
430 South Vine St.
Bastrop, LA 71220
Phone
(318) 283-3970
Fax
(318) 239-8970
NPI assigned
Mar 2, 2018
Last updated
Oct 24, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MOREHOUSE GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Authorized official

Name
Elmore Patterson
Title
Chief Executive Officer
Phone
(318) 283-3602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

430 South Vine St.
Bastrop, LA 71220

Mailing address

PO Box 293
Bastrop, LA 71221-0293
Phone (318) 283-3622

Other practice location 1

430 South Vine St.
Bastrop, LA 71220
Phone (318) 283-3970

Other names 1

  • Morehouse Family Medicine 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
O20180515002313 LA Part A Provider - Rural Health Clinic 4284528274 Practice locations: Bastrop, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1992207294. Details of each certification follow.

Rural health clinic certification: CCN 198520

Legal name
MOREHOUSE GENERAL HOSPITAL
Doing business as
MOREHOUSE FAMILY MEDICINE RURAL HEALTH CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Apr 7, 2020
Last certification
Apr 7, 2026
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
430 S Vine St
Bastrop, LA 71220-4514
Related CCNs
190116

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

Other NPIs with the same Medicare PAC ID 5

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

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
19D2030359Morehouse General Hospital Physicians Clinic430 South Vine St, Bastrop, LA 71220Provider-performed microscopySep 26, 2027

National Provider Directory

National Provider Directory
Tax ID family
Morehouse General Hospital5 organizations share this tax ID, including this one
Part of
Morehouse General Hospital

Other organizations with this tax ID 4

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.

Locations

206 S Vine St
Bastrop, LA 71220
Phone (318) 281-3521

314 N Franklin St
Ste A
Bastrop, LA 71220
Phone (318) 283-3890

8649 Highway 165 N
Monroe, LA 71203
Phone (318) 283-3684

9644 Highway 165 N
Sterlington, LA 71280
Phone (318) 283-3600

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
Richard Baland Individual Corporate OfficerChief Financial Officer Apr 23, 2025
Morehouse Parish Hospital Service District 1 Organization, Bastrop, LA 5% Or Greater Direct Ownership Interest Feb 1, 2022
Lindzay Wilmore Individual Corporate DirectorDirector of Revenue Cycle Jun 15, 2025
W-2 Managing EmployeeRevenue Cycle Director Apr 23, 2025

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Alliant Management ServicesBastrop, LA, CCN 19S116 Hospital Operational/Managerial Control (100%) Aug 1, 2020

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Practitioners 70

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 70

NPI Registry JSON

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

{
    "created_epoch": "1519948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1992207294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 293",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712210293",
            "telephone_number": "318-283-3622",
            "fax_number": "318-239-8622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 SOUTH VINE ST.",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "71220",
            "telephone_number": "318-283-3970",
            "fax_number": "318-239-8970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "430 South Vine St.",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "LA",
            "postal_code": "71220",
            "country_code": "US",
            "telephone_number": "318-283-3970",
            "fax_number": "318-239-8970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOREHOUSE GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOREHOUSE GENERAL HOSPITAL",
        "enumeration_date": "2018-03-02",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ELMORE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "318-283-3602"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Morehouse Family Medicine Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Morehouse Family Medicine Rural Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bastrop, LA

Sources for this page

Verify at the official NPI Registry.