INNIS COMMUNITY HEALTH CENTER, INC (NPI# 1417322892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417322892 |
| Entity Type | Organization |
| Organization Name | INNIS COMMUNITY HEALTH CENTER, INC |
| Other Organization Name | UPPER POINTE COUPEE ELEMENTARY SCHOOL |
| Practice Address |
4739 La Highway 419 Batchelor LA 70715-3472 |
| Mailing Address |
6450 Louisiana Highway 1 Batchelor LA 70715-3472 |
| Practice Telephone | 2254923775 |
| Practice Fax Number | 2254923782 |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | CINDDY PEAVY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2254923775 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2408119 | 05 |
| Other Name | Type Code |
|---|---|
| Upper Pointe Coupee Elementary School | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689138018 | Innis Community Health Center, Inc | Clinic/Center | 8434 Pointe Coupee Road, New Roads, LA 70760 | 2019-01-30 |
| 1013496561 | Innis Community Health Center, Inc | Clinic/Center | 630 North Vaughn Drive, Brusly, LA 70719 | 2018-08-07 |
| 1053841072 | Innis Community Health Center, Inc | Clinic/Center | 230 Roberts Dr Ste H, New Roads, LA 70760-2661 | 2017-06-13 |
| 1992170385 | Innis Community Health Center, Inc | Clinic/Center | 1100 New Roads St, New Roads, LA 70760-2300 | 2015-12-10 |
| 1184099574 | Innis Community Health Center, Inc | Clinic/Center | 3118 La Highway 78, Livonia, LA 70755 | 2015-12-10 |
| 1780059162 | Innis Community Health Center, Inc | Clinic/Center | 13258 La Highway 416, Rougon, LA 70773 | 2015-12-10 |
| 1538538863 | Innis Community Health Center, Inc | Clinic/Center | 77575 Landry Drive, Maringouin, LA 70757-3028 | 2015-09-16 |
| 1578986006 | Innis Community Health Center, Inc | Clinic/Center | 8737 Newfield Drive, Livonia, LA 70755 | 2014-02-04 |
| 1821287202 | Innis Community Health Center, Inc | Clinic/Center | 8366 Pointe Coupee Rd, Morganza, LA 70759-3320 | 2007-10-22 |
| 1003910167 | Innis Community Health Center, Inc | Clinic/Center | 8387 Newfield Dr, Livonia, LA 70755-3605 | 2006-09-11 |
| Street Address |
4739 LA HIGHWAY 419 |
| City | BATCHELOR |
| State | LA |
| Zip Code | 70715-3472 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140733 | Danielle Gros | Counselor | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2020-09-29 |
| 1043877889 | John Allen Russ | Dentist | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2019-05-28 |
| 1114377124 | Jeremy Brandon Courville | Nurse Practitioner | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2016-06-21 |
| 1205858388 | Innis Community Health Center, Inc | Clinic/Center | 6450 Louisiana Highway 1, Batchelor, LA 70715-6450 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275140733 | Danielle Gros | Counselor | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2020-09-29 |
| 1043877889 | John Allen Russ | Dentist | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2019-05-28 |
| 1114377124 | Jeremy Brandon Courville | Nurse Practitioner | 6450 La Highway 1, Batchelor, LA 70715-3212 | 2016-06-21 |
| 1205858388 | Innis Community Health Center, Inc | Clinic/Center | 6450 Louisiana Highway 1, Batchelor, LA 70715-6450 | 2006-07-24 |
| 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 |
|---|---|---|---|---|
| 1205858388 | Innis Community Health Center, Inc | Clinic/Center | 6450 Louisiana Highway 1, Batchelor, LA 70715-6450 | 2006-07-24 |
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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.