GPN-LEESVILLE, LLC (NPI# 1366929432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366929432 |
| Entity Type | Organization |
| Organization Name | GPN-LEESVILLE, LLC |
| Practice Address |
1020 W Fertitta Blvd Leesville LA 71446 |
| Mailing Address |
Po Box 722345 Norman OK 73070-8774 |
| Practice Telephone | 3372399041 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | CHRIS BEDDOE (CEO) |
| Authorized Official Telephone | 3182565691 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1017 W Fertitta Blvd, Leesville, LA 714464646 | 3373929524 | |
| 1201 W Fertitta Blvd, Leesville, LA 714464637 | 3373929438 | |
| 255 Highland Dr, Many, LA 714493717 | 3372386161 | |
| 325 W 8th St, Deridder, LA 706345505 | 3372390989 | |
| 412 S Pine St, Deridder, LA 706344840 | 3374625700 | |
| 427 N Pine St, Deridder, LA 706343905 | 3374626471 | |
| 506 S 6th St, Leesville, LA 714464482 | 3372390989 | |
| 700 S 6th St, Leesville, LA 714464719 | 3372380620 | |
| 927 Verone Ter, Leesville, LA 714464255 | 3372381049 | |
| 929 Verone Ter, Leesville, LA 714464255 | 3373929472 | |
| 18570 Johnny B. Hall Hwy, Rosepine, LA 70659 | 3374621913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013494186 | Gpn-leesville, LLC | Pathology | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2018-07-23 |
| 1043717515 | Gpn-leesville, LLC | Emergency Medicine | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2018-04-10 |
| Street Address |
1020 W FERTITTA BLVD |
| City | LEESVILLE |
| State | LA |
| Zip Code | 71446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801895495 | Byrd Medical Clinic Inc | Urology | 1020 W Fertitta Blvd, Leesville, LA 71446 | 2005-07-18 |
| 1881241552 | Kary Wilson | Physician Assistant | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2019-08-19 |
| 1912566779 | Oluwayemisi Radiology LLC | Radiology | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2019-06-06 |
| 1235693847 | Kisatchie Emergency Group, LLC | Physician Assistant | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2019-01-28 |
| 1538623640 | Clhg-leesville | General Acute Care Hospital | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2019-01-23 |
| 1013494186 | Gpn-leesville, LLC | Pathology | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2018-07-23 |
| 1043717515 | Gpn-leesville, LLC | Emergency Medicine | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2018-04-10 |
| 1972034155 | Jashua Bower | Nurse Practitioner | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2017-03-21 |
| 1548660855 | Juowen Huang | Pharmacist | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2014-08-25 |
| 1518255942 | Naga Malleswari Vutukuri | Internal Medicine | 1020 W Fertitta Blvd, Leesville, LA 71446-4645 | 2011-07-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699399048 | Just Health | Clinic/Center | 1203 South Fourth St, Leesville, LA 71446 | 2020-06-02 |
| 1487298964 | Usafetrans | Non-emergency Medical Transport (VAN) | 9348 Shreveport Hwy, Leesville, LA 71446 | 2019-10-29 |
| 1235634486 | Iberia Comprehensive Community Health Center, Inc. | Clinic/Center | 298 Nolan Trace Pkwy., Leesville, LA 71446 | 2018-03-29 |
| 1598280810 | Heather Wisby | Nurse Practitioner | 919 S. 10th St., Leesville, LA 71446 | 2017-08-08 |
| 1487183802 | Cathryn Lea Gaur | Speech-Language Pathologist | 300 Nolan Trace, Leesville, LA 71446 | 2017-06-08 |
| 1356708515 | Jessica Slaughter | Counselor | 1808 S 5th St, Suite A, Leesville, LA 71446 | 2016-01-19 |
| 1366820714 | Companion Care of Southwest Louisiana | In Home Supportive Care | 407 B North 5th Street, Leesville, LA 71446 | 2015-05-18 |
| 1760887673 | Great River Orthopedic and Sports Medicine Center, Inc. | Orthopaedic Surgery | 800 S. 3rd St., Leesville, LA 71446 | 2014-11-04 |
| 1003244781 | Byrd Regional Hospital | General Acute Care Hospital | 1020 W. Fertitta Blvd., Leesville, LA 71446 | 2013-10-16 |
| 1447500293 | Jana N Lambert | Nurse Practitioner | 919 S. 10th St, Leesville, LA 71446 | 2012-09-19 |
| Find all providers in zip 71446 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497148415 | Robert K. Lamme Md LLC | Family Medicine | 463 Art Perkins Rd, Leesville, LA 71446-5640 | 2015-03-16 |
| 1417379447 | West State Mht LLC | Family Medicine | 379 Peavy Rd, Leesville, LA 71446-9514 | 2014-01-10 |
| 1619123890 | Prashanth Pothem | Family Medicine | 1201 W Fertitta Blvd, Leesville, LA 71446-4637 | 2008-08-07 |
| 1497917280 | Timothy J Donovan | Family Medicine | 103 West University Parkway, Leesville, LA 71446-4482 | 2008-07-02 |
| 1548422181 | Robert Kenneth Lamme | Family Medicine | 1100 Nolan Trace Parkway, Leesville, LA 71446 | 2008-06-25 |
| 1558356196 | B-l Family Practice P A | Family Medicine | 608 E Columbia Ave, Leesville, SC 29070-7318 | 2005-09-20 |
| 1366437907 | Christy Clemenz Dunbar | Family Medicine | 608 East Columbia Ave, Leesville, SC 29070 | 2005-09-20 |
| 1609869353 | Melissa K Moss | Family Medicine | 802 S 10th St Ste C, Leesville, LA 71446-4662 | 2005-08-29 |
| 1417371279 | East State Mht LLC | Family Medicine | 506 S 6th St, Leesville, LA 71446-4482 | 2014-02-13 |
| 1679815294 | Timothy J Donovan Md LLC | Family Medicine | 103 West University Parkway, Leesville, LA 71446-4482 | 2013-03-21 |
| Find all providers in LEESVILLE | ||||
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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.