DAVID RAINES COMMUNITY HEALTH CENTER, INC (NPI# 1215933254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215933254 |
| Entity Type | Organization |
| Organization Name | DAVID RAINES COMMUNITY HEALTH CENTER, INC |
| Practice Address |
3041 Dr Martin Luther King Dr Shreveport LA 71107-4705 |
| Practice Telephone | 3182273350 |
| Practice Fax Number | 3182222979 |
| Mailing Telephone | 3182273350 |
| Mailing Fax Number | 3182222979 |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2015-03-05 |
| Authorized Official Name | MR. WILLIE C WHITE III (CEO) |
| Authorized Official Telephone | 3182273350 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1941638 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891964789 | David Raines Community Health Center, Inc | Clinic/Center | 1514 Doctors Dr, Bossier City, LA 71111-3379 | 2008-02-25 |
| 1598761496 | David Raines Community Health Center, Inc | Clinic/Center | 12763 Lay Street, Gilliam, LA 71029 | 2005-06-24 |
| 1912903964 | David Raines Community Health Center, Inc | Clinic/Center | 1953 Main St, Haynesville, LA 71038-4907 | 2005-06-23 |
| Street Address |
3041 DR MARTIN LUTHER KING DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71107-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891164141 | Yolanda C Bell | Dentist | 3041 Dr Martin Luther King Dr, Shreveport, LA 71107-4705 | 2015-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490875 | Kimber Leigh Lumley | Registered Nurse | 1440 Hawn Ave., Shreveport, LA 71107 | 2019-08-01 |
| 1871063461 | Nicole Capito | Case Manager/Care Coordinator | 200 North Thomas Drive Ste 1, Shreveport, LA 71107 | 2018-11-27 |
| 1891260899 | Danielle Leigh Dreher | Dental Assistant | 3610 Gorman Rd, Shreveport, LA 71107 | 2018-10-05 |
| 1255817540 | Shirley Marie Washington | Technician | 3227 Old Mooringsport Rd., Shreveport Rd, LA 71107 | 2018-07-19 |
| 1366928467 | Katrina L Bailey | Case Manager/Care Coordinator | 1111 Hawn Ave Apt A, Shreveport, LA 71107 | 2018-07-12 |
| 1063907970 | James Mcneely IIi | Public Health or Welfare | 5922 Alaska Ln, Shreveport, LA 71107 | 2018-06-25 |
| 1528560067 | Jacarie Guice | Case Manager/Care Coordinator | 4601 N. Market Ste 2, Shreveport, LA 71107 | 2018-03-01 |
| 1467971069 | Tracy Renard Harris | Counselor | 1149 Englemeade Dr, Shreveport, LA 71107 | 2017-09-14 |
| 1427588045 | Mark Rogers | Behavior Technician | 1500 N. Market Unit C Suite 105, Shreveport, LA 71107 | 2017-06-15 |
| 1356871164 | Hope4youth | Voluntary or Charitable | 2850 King Oaks Loop, Shreveport, LA 71107 | 2017-06-14 |
| Find all providers in zip 71107 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467061515 | Council for Advancement of Social Service and Education | Clinic/Center | 1560 Irving Place, Shreveport, LA 71101-4604 | 2020-07-24 |
| 1306455456 | Council for Advancement of Social Service and Education | Clinic/Center | 2120 Bert Kouns Industrial Loop Ste K-l, Shreveport, LA 71118-3351 | 2020-07-24 |
| 1760042394 | David Raines Community Health Center, Inc. | Clinic/Center | 4331 Henry St, Shreveport, LA 71109-6820 | 2019-06-17 |
| 1144705930 | David Raines Community Health Center Inc | Clinic/Center | 1625 David Raines Rd, Shreveport, LA 71107-5899 | 2018-09-27 |
| 1487178315 | David Raines Community Health Center, Inc. | Clinic/Center | 7611 Saint Vincent Ave, Shreveport, LA 71106-4231 | 2017-08-02 |
| 1760906630 | David Raines Community Health Center | Clinic/Center | 7340 Wyngate Blvd, Shreveport, LA 71106-3920 | 2017-08-01 |
| 1437673464 | David Raines Community Health Center, Inc. | Clinic/Center | 351 Hearne Ave, Shreveport, LA 71103-2019 | 2017-08-01 |
| 1760904981 | David Raines Community Health Center, Inc. | Clinic/Center | 401 W 70th St, Shreveport, LA 71106-3034 | 2017-07-10 |
| 1134532062 | Council for Advancement of Social Service and Education | Clinic/Center | 2120 Bert Kouns Industrial Loop, Suite A, Shreveport, LA 71118-3351 | 2014-06-09 |
| 1104249473 | David Raines Community Health Center, Inc. | Clinic/Center | 3021 W 70th St, Shreveport, LA 71108-4603 | 2014-01-22 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71107 |
Please comment or provide details below to improve the information on DAVID RAINES COMMUNITY HEALTH CENTER, INC.
| 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.