BEAUREGARD MEDICAL GROUP LLC (NPI# 1689126658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689126658 |
| Entity Type | Organization |
| Organization Name | BEAUREGARD MEDICAL GROUP LLC |
| Other Organization Name | SOUTH BEAUREGARD MEDICAL CENTER |
| Practice Address |
12186 Highway 171 Longville LA 70652 |
| Mailing Address |
12186 Highway 171 Longville LA 70652-4625 |
| Practice Telephone | 3372265301 |
| Mailing Telephone | 3374057778 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-02-04 |
| Authorized Official Name | MR. DAVID VIZINAT (OWNER/ PROVIDER) |
| Authorized Official Telephone | 3374057778 |
| Authorized Official Credential | APRN FNP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
AP08501 | LA | Ambulatory Health Care Facilities |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP08501 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AP08501 | LA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| South Beauregard Medical Center | Doing Business As Name - Organization |
| Street Address |
12186 HIGHWAY 171 |
| City | LONGVILLE |
| State | LA |
| Zip Code | 70652 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730455825 | David Vizinat | Nurse Practitioner | 12186 Highway 171, Longville, LA 70652-4625 | 2012-03-22 |
| 1427496462 | South Beauregard Health Center, L.L.C. | Clinic/Center | 12186 Highway 171, Longville, LA 70652-4625 | 2013-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861776957 | Laura Ellen Neely | Speech-Language Pathologist | 10619 Highway 171, Longville, LA 70652-4112 | 2011-10-06 |
| 1790086445 | Marguerite L Meaux | Registered Nurse | 275 Log Cabin Ln, Longville, LA 70652-4222 | 2010-11-11 |
| 1942255070 | Kathy Lynne Tracy | General Practice | 176 Longville Church Rd, Longville, LA 70652-5036 | 2006-05-24 |
| 1841642717 | Diabetes & Obesity Control LLC | General Practice | 176 Longville Church Rd, Longville, LA 70652-5036 | 2016-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548624778 | Nis Pharmacy Services, Ltd | Pharmacy | 1472 Cty Rd 5, Longville, MN 56655 | 2016-04-13 |
| 1083053292 | Gary F Wehrwein | Pharmacist | 1523 Suzanne Drive Ne, Longville, MN 56484 | 2013-06-20 |
| 1104260868 | Nis Pharmacy Services Ltd | Pharmacy | 1472 County Road 5, Longville, MN 56655-3002 | 2013-04-24 |
| 1760446868 | David W Laposky | Family Medicine | 180 Jordan Lane, Longville, MN 56655 | 2006-04-14 |
| 1629052584 | Elizabeth Ann Miles | Nurse Practitioner | 180 Jordan Ln, Longville Lakes Clinic, Longville, MN 56655 | 2005-12-05 |
| 1831293380 | Rachelle Marie Beseman | Physician Assistant | 180 Jordan Lane, Longville, MN 56655 | 2006-09-12 |
| 1861414518 | Cuyuna Regional Medical Center | Clinic/Center | 180 Jordan Lane, Longville, MN 56655 | 2006-07-24 |
| 1194700682 | David Roger Plattes | Family Medicine | 180 Jordan Ln, Longville Lakes Clinic, Longville, MN 56655-3164 | 2005-12-07 |
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427496462 | South Beauregard Health Center, L.L.C. | Clinic/Center | 12186 Highway 171, Longville, LA 70652-4625 | 2013-06-12 |
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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.