DRY PRONG FAMILY CLINIC, LLC (NPI# 1366928277) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366928277 |
| Entity Type | Organization |
| Organization Name | DRY PRONG FAMILY CLINIC, LLC |
| Other Organization Name | DRY PRONG FAMILY CLINIC |
| Practice Address |
800 Grove Street Dry Prong LA 71423 |
| Mailing Address |
Po Box 37 Montgomery LA 71454-0037 |
| Practice Telephone | 3185688298 |
| Practice Fax Number | 3185688297 |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | BENJAMIN COLVIN (OWNER) |
| Authorized Official Telephone | 3185688298 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dry Prong Family Clinic | Doing Business As Name - Organization |
| Street Address |
800 GROVE STREET |
| City | DRY PRONG |
| State | LA |
| Zip Code | 71423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528506813 | Anna Eyer | Counselor | 8622 Highway 71 N, Dry Prong, LA 71423 | 2017-02-07 |
| 1134397110 | Moreau Coutee Enterprises, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1004 Flagon Road, Pineville, LA 71423 | 2008-02-13 |
| 1427270081 | Healthy Outlook Management Enterprises | Nurse Practitioner | 2380 Airbase Rd, Dry Prong, LA 71423 | 2007-05-03 |
| 1598851107 | Danny Dee Dauzat | Occupational Therapist | 3380 Grays Creek Rd, 3380 Grays Creek Rd, Dry Prong, LA 71423 | 2006-10-04 |
| 1447523626 | Total Health Chiropractic Center, LLC | Chiropractor | 19548 Highway 167, Dry Prong, LA 71423-3400 | 2012-02-17 |
| 1740745751 | Georgia Moran | Case Manager/Care Coordinator | 20895 Highway 167, Dry Prong, LA 71423-3438 | 2019-02-04 |
| 1629012984 | Paul Cade Hargis | Dentist | 20970 Highway 167, Dry Prong, LA 71423-3468 | 2006-06-16 |
| 1750768495 | Rita D Martin | Counselor | 259 Prospect Rd, Dry Prong, LA 71423-3479 | 2015-05-01 |
| 1174080816 | Roc With Knowledge & Grit, Inc. | Psychoanalyst | 259 Prospect Rd, Dry Prong, LA 71423-3479 | 2019-03-01 |
| 1912269846 | Janell Newton | Registered Nurse | 679 Grays Creek Rd, Dry Prong, LA 71423-3528 | 2012-06-15 |
| Find all providers in zip 71423 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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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.