KENTWOOD FAMILY CLINIC LLC (NPI# 1780050294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780050294 |
| Entity Type | Organization |
| Organization Name | KENTWOOD FAMILY CLINIC LLC |
| Practice Address |
919 Avenue G Kentwood LA 70444 |
| Mailing Address |
1509 Dulles Dr Lafayette LA 70506-3718 |
| Practice Telephone | 3379919276 |
| Practice Fax Number | 3379919288 |
| Mailing Telephone | 3379919276 |
| Mailing Fax Number | 3379919288 |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2020-03-02 |
| Authorized Official Name | NICOLE HOWARD (CEO) |
| Authorized Official Telephone | 3379919276 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Street Address |
919 AVENUE G |
| City | KENTWOOD |
| State | LA |
| Zip Code | 70444 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407177348 | Bryan D. Tate Jr. | Nurse Practitioner | 919 Avenue G, Kentwood, LA 70444 | 2010-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437703733 | Bridge Builders Consultants, LLC | In Home Supportive Care | Bridge Builders Consultants, LLC, 505 Avenue F, Ste A, Kentwood, LA 70444 | 2019-07-25 |
| 1336577576 | Penny Scardulla | Pharmacist | 717 Ave. G, Kentwood, LA 70444 | 2013-10-25 |
| 1891034716 | Freds Stores of Tennessee Inc | Pharmacy | 734 Avenue G # 38, Kentwood, LA 70444 | 2013-02-13 |
| 1174737720 | Harmony Center, Inc. | Intermediate Care Facility, Mental Illness | 1551 Cb Temple Sr. Road, Kentwood, LA 70444 | 2007-05-10 |
| 1467670349 | Daryl Marshall Westmoreland Sr. | Dentist | 68144 Highway 51, 68144 Highway 51, Kentwood, LA 70444-0432 | 2007-04-23 |
| 1962989053 | Lets Keep It Moving Transportation | Non-emergency Medical Transport (VAN) | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-23 |
| 1174009351 | Tamika Dickerson | Driver | 412 7th St, Kentwood, LA 70444-2308 | 2018-07-11 |
| 1013468909 | Southeast Community Health Systems | Clinic/Center | 603 9th St, Kentwood, LA 70444-2317 | 2016-10-17 |
| 1144871229 | Ezer Medical Transportation, Inc | Non-emergency Medical Transport (VAN) | 505 Avenue F Ste D, Kentwood, LA 70444-2347 | 2019-09-20 |
| 1104969286 | Troy Michael Verges | Dentist | 207 Ave. G, Kentwood, LA 70444-2522 | 2007-02-15 |
| Find all providers in zip 70444 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1720606478 | Dr Lawanda Lamar Bellamy Md A Professional Medical Corporation | Clinic/Center | 1307 Crowley-rayne Hwy, Suite B, Crowley, LA 70526 | 2020-07-09 |
| 1669002002 | Franklin Parish Hospital Service Dist 1 | Clinic/Center | 7645 Gilbert Street, Gilbert, LA 71336 | 2020-01-24 |
| 1184260937 | Children's International, LLC | Clinic/Center | 5151 Plank Rd Ste 190, Baton Rouge, LA 70805-3501 | 2019-11-26 |
| 1003467440 | Clhg-acadian LLC | Clinic/Center | 151 Hill St Ste 102, Eunice, LA 70535-5845 | 2019-09-26 |
| 1164073524 | Tangi Wellness & Health | Clinic/Center | 906 C M Fagan Dr Ste B3, Hammond, LA 70403-6056 | 2019-09-26 |
| 1679126510 | Pediatric Group of Acadiana, LLC | Clinic/Center | 1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210 | 2019-07-19 |
| 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.