SOUTH LOUISIANA PRIMARY CARE LLC (NPI# 1447705074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1447705074 |
Entity Type | Organization |
Organization Name | SOUTH LOUISIANA PRIMARY CARE LLC |
Practice Address |
12902 Plank Rd Baker LA 70714-4911 |
Practice Telephone | 2252184816 |
Practice Fax Number | 2253025057 |
Mailing Telephone | 2252184816 |
Mailing Fax Number | 2253025057 |
Enumeration Date | 2016-08-24 |
Last Update Date | 2016-08-24 |
Authorized Official Name | MR. DUSTIN LOGUE (OWNER) |
Authorized Official Telephone | 2252184816 |
Authorized Official Credential | APRN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AP06078 | LA | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 2110691 | 05 |
Street Address |
12902 PLANK RD |
City | BAKER |
State | LA |
Zip Code | 70714-4911 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205106820 | Ernest Gene Thompson Jr Md Apmc | Internal Medicine | 12902 Plank Rd, Baker, LA 70714-4911 | 2012-01-12 |
1508414855 | Hailey Mcmanus Murphy | Nurse Practitioner | 12902 Plank Rd, Baker, LA 70714-4911 | 2019-08-29 |
1326453689 | Rebecca A Davis Fnp-c LLC | Nurse Practitioner | 12902 Plank Rd, Baker, LA 70714-4911 | 2014-06-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710406574 | Chasity Davis | Counselor | 12753 Plank Rd Apt 32, Baker, LA 70714 | 2017-09-13 |
1417486895 | Cicella Lorine Benton | Counselor | 3327 Grant St, Baker, LA 70714 | 2017-06-08 |
1447782594 | I Know I Can Speech-language Therapy Services | Early Intervention Provider Agency | 7206 Juno Drive, Baker, LA 70714 | 2017-03-29 |
1265880488 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3622 Groom Road, Baker, LA 70714 | 2016-05-27 |
1013363241 | Micon Gaines | Counselor | 4206 N. Morvant Pl., Baker, LA 70714 | 2016-05-06 |
1932564549 | Clifton Hunt | Case Manager/Care Coordinator | 3276 Jackson St, Baker, LA 70714 | 2015-12-24 |
1992174833 | A Loving Heart Medical Transportation,llc | Non-emergency Medical Transport (VAN) | 5401 Rue Nicole, Baker, LA 70714 | 2015-09-22 |
1174927685 | Unique Healthcare Options | Clinic/Center | 1877 Heck Young Rd, Baker, LA 70714 | 2014-10-13 |
1972934263 | Freds Stores of Tennessee Inc | Pharmacy | 312 Main Street Hwy 19, Baker, LA 70714 | 2013-12-11 |
1245665157 | Cope Behavior Health, LLC | Community Based Residential Treatment Facility, Mental Illness | 4425 Groom Road, Suite B, Baker, LA 70714 | 2013-09-10 |
Find all providers in zip 70714 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174927685 | Unique Healthcare Options | Clinic/Center | 1877 Heck Young Rd, Baker, LA 70714 | 2014-10-13 |
1699177345 | Mcms, LLC | Clinic/Center | 17625 Wisdom Dr, Baker, LA 70714-1536 | 2014-09-24 |
1407371479 | Mercy Primary Care Home Visits | Clinic/Center | 8519 Pettit Rd, Baker, LA 70714-6425 | 2017-08-10 |
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1124659164 | Diana L. Corley, Fnp, LLC | Clinic/Center | 1015 Hwy 107, Centerpoint, LA 71323 | 2020-01-29 |
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1518503754 | Optimus Primary Care, LLC | Clinic/Center | 13828 Coursey Boulevard, Address Line 2, Baton Rouge, LA 70817 | 2019-11-22 |
1992367791 | Family First Medical & Wellness Clinic, LLC | Clinic/Center | 300 Clay St, Kenner, LA 70062 | 2019-07-01 |
1366926040 | In and Out Urgent Care Covington, LLC | Clinic/Center | 13130 Hwy 1085, Suite 100, Covington, LA 70433-7829 | 2018-09-19 |
1588143556 | Pediatric Center of Many LLC | Clinic/Center | 315 S Highland Dr Ste A, Many, LA 71449-3719 | 2018-08-10 |
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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.