LOUISIANA FAMILY MEDICINE CLINIC 1 (NPI# 1548538200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548538200 |
| Entity Type | Organization |
| Organization Name | LOUISIANA FAMILY MEDICINE CLINIC 1 |
| Practice Address |
103 Watts St Jonesboro LA 71251-2053 |
| Practice Telephone | 3182591569 |
| Practice Fax Number | 3182598523 |
| Mailing Telephone | 3182591569 |
| Mailing Fax Number | 3182598523 |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2015-06-18 |
| Authorized Official Name | DIRK TIMOTHY RAINWATER (CEO) |
| Authorized Official Telephone | 3185603486 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
025000 | LA | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | 025000 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2344188 | 05 |
| Street Address |
103 WATTS ST |
| City | JONESBORO |
| State | LA |
| Zip Code | 71251-2053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043286230 | Dirk Timothy Rainwater | Emergency Medicine | 103 Watts St, Jonesboro, LA 71251-2053 | 2006-02-27 |
| 1417505413 | Elyse Mills | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2019-09-03 |
| 1821641374 | Latosha Jackson Mollette | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2019-07-23 |
| 1720528680 | Alison Creel | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2017-02-27 |
| 1548629090 | Adam Lawson | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2016-02-12 |
| 1326419789 | Mandy Katheryn Mcnamara | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2015-10-12 |
| 1083094007 | Louisiana Family Medicine Clinic, Inc. | Non-Pharmacy Dispensing Site | 103 Watts St, Jonesboro, LA 71251-2053 | 2015-06-04 |
| 1699058354 | Quality Care Center | Nurse Practitioner | 103 Watts St, Jonesboro, LA 71251-2053 | 2011-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962985432 | Jonathan Rogers | Non-emergency Medical Transport (VAN) | 131 Eden Circle, Jonesboro, LA 71251 | 2018-09-11 |
| 1891273546 | Charlotte Amos | Case Manager/Care Coordinator | 248 Collin Rd, Jonesboro, LA 71251 | 2018-08-04 |
| 1528429578 | Lisa Hammock | Counselor | 124 Hudson Ave, Jonesboro, LA 71251 | 2016-03-17 |
| 1851752661 | Monique Burks | Behavioral Analyst | 103 4th Street, Stepping Stones, Jonesboro, LA 71251 | 2016-03-08 |
| 1184080046 | Deon Jones | Counselor | 206 Hudson Ave, Jonesboro, LA 71251 | 2016-01-07 |
| 1942672894 | Timothy Stewart | Behavioral Analyst | 201 Forest Dr, Jonesboro, LA 71251 | 2015-10-29 |
| 1871964148 | Stacey Harrell | Social Worker | 305 Cobb Dr, Jonesboro, LA 71251 | 2015-10-13 |
| 1528398799 | Alesia Fortune | Behavioral Analyst | 103 4th St, Jonesboro, LA 71251 | 2010-01-11 |
| 1184848756 | Mayfield Chiropractic Jonesboro, LLC | Chiropractor | 520 S. Polk St., Jonesboro, LA 71251 | 2007-04-12 |
| 1093793408 | Jackson Parish Hospital | General Acute Care Hospital | 165 Beech Springs Rd, Jonesboro, LA 71251 | 2006-01-05 |
| Find all providers in zip 71251 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
| 1003450230 | Raising The Standards of Care LLC | Clinic/Center | 361 Southwest Dr Ste 771, Jonesboro, AR 72401-5854 | 2019-10-31 |
| 1508411422 | Sbs Investments LLC | Clinic/Center | 3114 Fox Rd Ste D, Jonesboro, AR 72404-9577 | 2019-08-07 |
| 1467639435 | Chiropractic Plus, LLC | Clinic/Center | 2244 Mount Zion Rd, Jonesboro, GA 30236 | 2008-01-22 |
| 1649459512 | Harrah Family Chiropractic Clinic | Clinic/Center | 1007 Windover Rd Ste C, Jonesboro, AR 72401-6009 | 2007-10-29 |
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| 1124645130 | Bayou Telemedicine LLC | Clinic/Center | 1703 Arizona Ave, Monroe, LA 71202-3632 | 2020-06-26 |
| 1699392589 | Minden Physician Practices LLC | Clinic/Center | 170 Healthcare Plaza, Haughton, LA 71037 | 2020-06-26 |
| 1245853803 | Alexandria Primary Care Clinic | Clinic/Center | 224 Pecan Park Ave Rm B1, Alexandria, LA 71303-3308 | 2020-05-18 |
| 1326676479 | Royal Health & Wellness Clinic LLC | Clinic/Center | 108 Riverbirch Dr, Lafayette, LA 70508-1819 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
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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.