LIVING WELL FAMILY CLINIC LLC (NPI# 1821413535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821413535 |
| Entity Type | Organization |
| Organization Name | LIVING WELL FAMILY CLINIC LLC |
| Practice Address |
1643 Carter St Suite 1 Vidalia LA 71373-3156 |
| Practice Telephone | 3183368707 |
| Practice Fax Number | 3183368776 |
| Mailing Telephone | 3183368707 |
| Mailing Fax Number | 3183368776 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2014-05-15 |
| Authorized Official Name | MRS. CHARLA W KNAPP (CO-OWNER) |
| Authorized Official Telephone | 3183368707 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1882372 | 05 | |
| MS | 01926528 | 05 |
| Street Address |
1643 CARTER ST SUITE 1 |
| City | VIDALIA |
| State | LA |
| Zip Code | 71373-3156 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780190322 | Concordia Parish Hospital Service District Number One | Clinic/Center | 1643 Carter St, Vidalia, LA 71373-3156 | 2017-12-19 |
| 1932648565 | Melissa Johnson | Nurse Practitioner | 1643 Carter St, Vidalia, LA 71373-3156 | 2017-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513494 | Total Urgent Care | Clinic/Center | 4014 Carter Street, Vidalia, LA 71373 | 2020-03-13 |
| 1609412097 | Hulin Urgent Care Services, LLC | Clinic/Center | 4319 Highway 84, Vidalia, LA 71373 | 2019-11-21 |
| 1720562556 | Neashion Marie Davis | Counselor | 1644 B Carter Street. Suite #2, Vidalia, LA 71373 | 2018-09-18 |
| 1992292403 | Angelica Francheska Woods | Counselor | 1644 B. Carter Street Suite 2, Vidalia, LA 71373 | 2018-04-19 |
| 1164973780 | Linda Sherbia | Counselor | 1644 B Carter St., Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1518418045 | Cheryl Clark | Case Manager/Care Coordinator | 1644 B Carter Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1972054500 | Sherry Cade | Counselor | 1644 B Carter Street, Suite 2, Vidalia, LA 71373 | 2016-10-19 |
| 1457801136 | Sarai Johnson | Counselor | 1644 B Carter Street Suite 2, Vidalia, LA 71373 | 2016-10-06 |
| 1053766410 | Erin Fournet Woodruff | Physical Therapist | 402 Holly Street, Vidalia, LA 71373 | 2016-05-04 |
| 1184084113 | Troy Nolan Thomas Jr. | Counselor | 4012 Carter St., Vidalia, LA 71373 | 2016-03-03 |
| Find all providers in zip 71373 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1962826511 | Accordia Healthcare LLC | Clinic/Center | 3193 E 1st St, Vidalia, GA 30474-8830 | 2014-02-18 |
| 1316251051 | Riverpark Primary Health Clinic, LLC. | Clinic/Center | 107 Front Street, Vidalia, LA 71373 | 2010-08-05 |
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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.