MOREHOUSE GENERAL HOSPITAL (NPI# 1790966638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790966638 |
| Entity Type | Organization |
| Organization Name | MOREHOUSE GENERAL HOSPITAL |
| Practice Address |
323 W Walnut Ave Bastrop LA 71220-4521 |
| Mailing Address |
Po Box 1060 Bastrop LA 71221-1060 |
| Practice Telephone | 3182833600 |
| Practice Fax Number | 3182398600 |
| Mailing Telephone | 3182833710 |
| Mailing Fax Number | 3182398710 |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2019-11-22 |
| Authorized Official Name | MR. DERRICK FRAZIER (CEO) |
| Authorized Official Telephone | 3182833601 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOREHOUSE GENERAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1797138 | 05 |
| Other Name | Type Code |
|---|---|
| Morehouse General Hospital HBP | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 416 Gunby Ave, Bastrop, LA 712204406 | 3182618746 | 3182811133 |
| 416 Gunby Ave, Bastrop, LA 712204406 | 3182833950 | 3182398950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003898313 | Morehouse General Hospital | General Acute Care Hospital | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2005-11-14 |
| 1992207294 | Morehouse General Hospital | Clinic/Center | 221 W Hickory Ave, Bastrop, LA 71220 | 2018-03-02 |
| 1376089359 | Morehouse General Hospital | Psychiatric Unit | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2017-01-13 |
| 1245544923 | Morehouse General Hospital | Nurse Practitioner | 420 Gunby Ave, Bastrop, LA 71220-4406 | 2010-08-05 |
| 1831202720 | Morehouse General Hospital | Medicare Defined Swing Bed Unit | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2006-08-16 |
| Street Address |
323 W WALNUT AVE |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-4521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003898313 | Morehouse General Hospital | General Acute Care Hospital | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2005-11-14 |
| 1376089359 | Morehouse General Hospital | Psychiatric Unit | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2017-01-13 |
| 1255777934 | Kei Nagatomo | Surgery | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2013-05-21 |
| 1942551627 | April D Temple | Dietitian, Registered | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2012-09-21 |
| 1275810699 | Yolanda Lafaye Starr | Nurse Practitioner | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2011-11-14 |
| 1518254713 | Lisa Michelle Faulkenbury | Nurse Practitioner | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2011-07-07 |
| 1649436080 | Morehouse Hyperbaric Medicine Providers, LLC | Legal Medicine | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2008-08-05 |
| 1568633048 | Shannon L Grantham | Counselor | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2008-03-12 |
| 1831202720 | Morehouse General Hospital | Medicare Defined Swing Bed Unit | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2006-08-16 |
| 1366480030 | Jay Mashburn | Emergency Medicine | 323 W Walnut Ave, Bastrop, LA 71220-4521 | 2006-06-03 |
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|---|---|---|---|---|
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| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
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| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
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| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
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| 1356906911 | Allied Medicine Inc | Clinic/Center | 620 Bayou Tortue, Rd Suite 1, Broussard, LA 70518 | 2019-05-08 |
| 1356808430 | Cenikor Foundation | Clinic/Center | 2414 Bunker Hill Dr Ste 100, Baton Rouge, LA 70808-3303 | 2019-02-26 |
| 1063983799 | Accessible Walk-in Clinic | Clinic/Center | 1206 J W Davis Dr Ste 102, Hammond, LA 70403-5953 | 2018-12-06 |
| 1235616194 | Pathways Addiction Recovery, LLC | Clinic/Center | 3801 Houma Blvd Ste 100, Metairie, LA 70006-4185 | 2018-07-24 |
| 1063915866 | Gulf Coast Medical Center | Clinic/Center | 51 Holmes Blvd Ste A, Terrytown, LA 70056-2592 | 2018-03-18 |
| 1437660115 | Edge Medical Services Inc. | Clinic/Center | 2100 E 70th St, Shreveport, LA 71105-5363 | 2017-10-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.