LOUISIANA FAMILY MEDICINE CLINIC, INC. (NPI# 1083094007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083094007 |
| Entity Type | Organization |
| Organization Name | LOUISIANA FAMILY MEDICINE CLINIC, INC. |
| Practice Address |
103 Watts St Jonesboro LA 71251-2053 |
| Practice Telephone | 3182591569 |
| Practice Fax Number | 3182598523 |
| Mailing Telephone | 3182591569 |
| Mailing Fax Number | 3182598523 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2015-06-04 |
| Authorized Official Name | DIRK RAINWATER (OWNER) |
| Authorized Official Telephone | 3182591569 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| Street Address |
103 WATTS ST |
| City | JONESBORO |
| State | LA |
| Zip Code | 71251-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043286230 | Dirk Timothy Rainwater | Emergency Medicine | 103 Watts St, Jonesboro, LA 71251-2053 | 2006-02-27 |
| 1417505413 | Elyse Mills | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2019-09-03 |
| 1821641374 | Latosha Jackson Mollette | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2019-07-23 |
| 1720528680 | Alison Creel | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2017-02-27 |
| 1548629090 | Adam Lawson | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2016-02-12 |
| 1326419789 | Mandy Katheryn Mcnamara | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2015-10-12 |
| 1548538200 | Louisiana Family Medicine Clinic 1 | Clinic/Center | 103 Watts St, Jonesboro, LA 71251-2053 | 2011-12-09 |
| 1699058354 | Quality Care Center | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962985432 | Jonathan Rogers | Non-emergency Medical Transport (VAN) | 131 Eden Circle, Jonesboro, LA 71251 | 2018-09-11 |
| 1891273546 | Charlotte Amos | Case Manager/Care Coordinator | 248 Collin Rd, Jonesboro, LA 71251 | 2018-08-04 |
| 1528429578 | Lisa Hammock | Counselor | 124 Hudson Ave, Jonesboro, LA 71251 | 2016-03-17 |
| 1851752661 | Monique Burks | Behavioral Analyst | 103 4th Street, Stepping Stones, Jonesboro, LA 71251 | 2016-03-08 |
| 1184080046 | Deon Jones | Counselor | 206 Hudson Ave, Jonesboro, LA 71251 | 2016-01-07 |
| 1942672894 | Timothy Stewart | Behavioral Analyst | 201 Forest Dr, Jonesboro, LA 71251 | 2015-10-29 |
| 1871964148 | Stacey Harrell | Social Worker | 305 Cobb Dr, Jonesboro, LA 71251 | 2015-10-13 |
| 1528398799 | Alesia Fortune | Behavioral Analyst | 103 4th St, Jonesboro, LA 71251 | 2010-01-11 |
| 1184848756 | Mayfield Chiropractic Jonesboro, LLC | Chiropractor | 520 S. Polk St., Jonesboro, LA 71251 | 2007-04-12 |
| 1093793408 | Jackson Parish Hospital | General Acute Care Hospital | 165 Beech Springs Rd, Jonesboro, LA 71251 | 2006-01-05 |
| Find all providers in zip 71251 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407461593 | Scott G Petrie Md Apmc | Non-Pharmacy Dispensing Site | 1014 West St Clare Boulevard, Ste 1020, Gonzales, LA 70737 | 2020-09-15 |
| 1689282576 | Total Access Mobility Services | Non-Pharmacy Dispensing Site | 500 Port of New Orleans Pl, New Orleans, LA 70130-1662 | 2020-07-17 |
| 1023570348 | Patrick A Juneau, IIi, Md, Apmc | Non-Pharmacy Dispensing Site | 1103 Kaliste Saloom Rd Ste 206, Lafayette, LA 70508-5784 | 2019-04-04 |
| 1306304050 | Spinal Regeneration Center of La, LLC | Non-Pharmacy Dispensing Site | 189 Greenbrier Blvd Ste C, Covington, LA 70433-7297 | 2019-03-12 |
| 1700356789 | John R. Macgregor Jr. M.d. (apmc) | Non-Pharmacy Dispensing Site | 1502 West Causeway Approach, Suite D, Mandeville, LA 70471 | 2018-12-03 |
| 1124502505 | Orthopaedic Clinic of Monroe | Non-Pharmacy Dispensing Site | 1501 Louisville Ave., Monroe, LA 71201 | 2018-09-20 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1902385354 | Wm. Andre Cenac, Md Apmc | Non-Pharmacy Dispensing Site | 1307 Old Jeanerette Rd Ste 100, New Iberia, LA 70563-5801 | 2018-08-07 |
| 1801394820 | Acadiana Ambulatory Health Care Services | Non-Pharmacy Dispensing Site | 207 Westmark Blvd., Lafayette, LA 70506 | 2018-01-24 |
| 1144734153 | Northshore Interventional Pain Management | Non-Pharmacy Dispensing Site | 7015 Hwy 190 E Service Rd., Ste 101, Covington, LA 70433 | 2017-11-29 |
| Find all providers with the same taxonomy | ||||
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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.