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MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC
NPI 1104890052
Orthopaedic Surgery in Alexandria, LA

Active since February 16, 2006
3444 MASONIC DRIVE, ALEXANDRIA, LA 71301(318) 473-9556(318) 441-8339 Get Directions Write a Review

NPPES record last updated: March 24, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 24, 2026, Jan 2, 2024, Jul 5, 2022 and 1 more (4 updates tracked since 2021).

About Mid State Orthopaedic & Sports Medicine Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC (NPI 1104890052), doing business as Mid-state Orthopaedic & Sports Medicine Center Inc, is a healthcare organization registered as an orthopaedic surgery in Alexandria, Louisiana and active in the NPI registry since February 2006. The organization maintains a secondary practice location in Pineville and lists Nakita C Hickman, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1104890052
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameMID STATE ORTHOPAEDIC & SPORTS MEDICINE CENTER, LLC
Location Address3444 MASONIC DRIVEAlexandria, LA 71301
Mailing Address3444 Masonic DriveAlexandria, LA 71301 · (318) 473-9556 · Fax (318) 441-8339
Phone(318) 473-9556
Fax(318) 441-8339
Organization SubpartNo
Authorized OfficialNakita C HickmanCredentialing Manager · (318) 441-8329
Enumeration DateFebruary 16, 2006
Last NPPES UpdateMarch 24, 20264 updates tracked since enumeration
NPPES CertifiedMarch 24, 2026
✔ NPI 1104890052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedPhysical TherapistTaxonomy 225100000X
Also ListedOccupational TherapistTaxonomy 225X00000X
3444 MASONIC DRIVE, Alexandria, LA 71301
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Other Names 1

Former Legal Business NameMid-state Orthopaedic & Sports Medicine Center Inc

Secondary Practice Location 1

Location 1429 Rocky Bayou DrPineville, LA 71360-8133 · Phone (318) 441-8329

Other Identifiers 3

Other0570570001LA · Medicare Dme Group #
OtherCD7720LA · Railroad Medicare Palmett
Medicaid1946320LA

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Blue Cross and Blue Shield of Louisiana, HMO Louisiana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mid State Orthopaedic & Sports Medicine Center, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

21

Medicare enrollment records show 21 clinicians reassign Medicare billing to Mid State Orthopaedic & Sports Medicine Center, LLC, which bills Medicare for the services they deliver. Of these, 12 practice at this address and 21 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 7

Orthopedic Surgery6
Nurse Practitioner4
Physical Therapist in Private Practice4
Occupational Therapist in Private Practice3
Sports Medicine2
Physical Medicine and Rehabilitation1
Psychiatry1

Nearest to this location (20)

See all 21
Larry Doughty, M.D.
Psychiatry
NPI 1922549211
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts MedicareSame address
Jeffrey Garrison, M.D.
Orthopedic Surgery
NPI 1104849009
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOSSame address
Mandy Guilliams, FNP-C
Nurse Practitioner
NPI 1578291258
3444 MASONIC DR
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts MedicareSame address
Jeanne Harrison, FNP-C
Nurse Practitioner
NPI 1740694793
3444 MASONIC DR
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts MedicareSame address
Janssen Meeker, DPT
Physical Therapist in Private Practice
NPI 1417409996
3444 MASONIC DR
Alexandria, LA 71301
(318) 441-8329
✔ Accepts MedicareSame address
Miles Parsons, M.D.
Orthopedic Surgery
NPI 1407385586
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOSSame address
Timmothy Randell, M.D.
Orthopedic Surgery
NPI 1245460013
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOSSame address
Jamie Rister, M.D.
Sports Medicine
NPI 1770801763
3444 MASONIC DR
Alexandria, LA 71301
(318) 473-9556
✔ PECOSSame address
William Rogenmoser, D.O.
Physical Medicine and Rehabilitation
NPI 1902171176
3444 MASONIC DR
Alexandria, LA 71303
(318) 319-6730
✔ PECOSSame address
Amy Stallings, P.T.
Physical Therapist in Private Practice
NPI 1871151399
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ Accepts MedicareSame address
Rashad Sullivan, MD
Orthopedic Surgery
NPI 1174962856
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts MedicareSame address
James Thomas, FNP-C
Nurse Practitioner
NPI 1568901874
3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts MedicareSame address
William Crenshaw, M.D.
Orthopedic Surgery
NPI 1700099538
3351 MASONIC DR
Alexandria, LA 71301
(318) 473-9556
✔ PECOS0.3 mi
Michael Leddy, MD
Sports Medicine
NPI 1821052028
3351 MASONIC DR
Alexandria, LA 71301
(318) 473-9556
✔ PECOS0.3 mi
George Lacour, OTR, CHT
Occupational Therapist in Private Practice
NPI 1477599645
3347 MASONIC DR
Alexandria, LA 71301
(318) 443-3311
✔ Accepts Medicare0.3 mi
Daniel Oas, D.O.
Orthopedic Surgery
NPI 1093782443
MID STATE ORTHOAPEDIC AND SPORTS MEDICINE CENTER, LLC 3444 MASONIC DRIVE
Alexandria, LA 71301
(318) 473-9556
✔ PECOS✔ Accepts Medicare0.4 mi
Rebecca Smilie, P.T.
Physical Therapist in Private Practice
NPI 1669775805
3704 NORTH BLVD STE C
Alexandria, LA 71301
(318) 473-2230
✔ Accepts Medicare0.6 mi
Jessica Swanson, NP
Nurse Practitioner
NPI 1801525969
201 4TH ST STE 5A
Alexandria, LA 71301
(318) 483-1961
✔ PECOS✔ Accepts Medicare2.6 mi
Abby Fennell, O.T.
Occupational Therapist in Private Practice
NPI 1740887694
429 ROCKY BAYOU DRIVE
Pineville, LA 71360
(318) 545-4120
✔ Accepts Medicare5.5 mi
Tori Anne Peery, PT, DPT
Physical Therapist in Private Practice
NPI 1508611534
429 ROCKY BAYOU DR
Pineville, LA 71360
(318) 545-4120
✔ Accepts Medicare5.5 mi
See all 21 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Medical Equipment Supplier Medicare DMEPOS 10

Medicare supplier enrollment and the product categories Mid-State Orthopaedic And Sports Me carries, from the Medicare DMEPOS supplier directory.

Mid-State Orthopaedic And Sports Me

DMEPOS supplier · Alexandria, LAOperated by Mid State Orthopaedic & Sports Medicine Center LLC
✔

Accepts Medicare assignment

Mid-State Orthopaedic And Sports Me agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20667641
Medicare Participant SinceMay 16, 1996
Supplier Location3444 Masonic DrAlexandria, LA 71301
Provider TypePhysician – Orthopedic/Orthopedic Surgery · Physician – Podiatry
Supplier Specialties
Orthotic Personnel

Medicare Product Categories

Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Walkers
Standard Walkers, Wheeled Walkers, Folding Walker
Wheelchairs (Standard Manual Related Accessories)
Accessories for standard wheelchairs, transport wheelchairs, heavy duty wheelchairs
Wheelchairs (Standard Power)
Standard power wheelchairs, Heavy duty standard power wheelchairs
Wheelchair Seating/Cushions
Wheelchair seat cushions, Wheelchair bank cushions, Wheelchair padded armrests
Orthoses: Custom Fabricated
Custom met pads, Custom heel pads, Custom heel spur pads
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mid State Orthopaedic & Sports Medicine Center, LLC's NPI number?

The NPI number for Mid State Orthopaedic & Sports Medicine Center, LLC is 1104890052. It was assigned to this organization in the NPPES registry on February 16, 2006. The provider was formerly known as Mid-State Orthopaedic & Sports Medicine Center Inc.

Where is Mid State Orthopaedic & Sports Medicine Center, LLC located?

Mid State Orthopaedic & Sports Medicine Center, LLC is located at 3444 Masonic Drive, Alexandria, LA 71301. The listed phone number is (318) 473-9556.

What is Mid State Orthopaedic & Sports Medicine Center, LLC's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Mid State Orthopaedic & Sports Medicine Center, LLC enrolled in Medicare?

Yes. Mid State Orthopaedic & Sports Medicine Center, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mid State Orthopaedic & Sports Medicine Center, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 21 clinicians in 7 Medicare specialties reassign their Medicare billing to Mid State Orthopaedic & Sports Medicine Center, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Orthopedic Surgery (6), Nurse Practitioner (4) and Physical Therapist in Private Practice (4). Of these, 12 practice at this address and 21 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mid State Orthopaedic & Sports Medicine Center, LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Mid-State Orthopaedic And Sports Me accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

What insurance does Mid State Orthopaedic & Sports Medicine Center, LLC accept?

Health plans from AmeriHealth Caritas Next, Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Mid State Orthopaedic & Sports Medicine Center, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mid State Orthopaedic & Sports Medicine Center, LLC was last updated on March 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.