BEAUREGARD PHYSICIAN GROUP, LLC (NPI# 1780814756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780814756 |
| Entity Type | Organization |
| Organization Name | BEAUREGARD PHYSICIAN GROUP, LLC |
| Practice Address |
600 S Pine St Deridder LA 70634-4942 |
| Mailing Address |
Po Box 730 Deridder LA 70634-0730 |
| Practice Telephone | 3374627106 |
| Practice Fax Number | 3374627479 |
| Mailing Telephone | 3374627106 |
| Mailing Fax Number | 3374627479 |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2017-04-13 |
| Authorized Official Name | MR. DARRELL L KINGHAM I (CFO) |
| Authorized Official Telephone | 3374627111 |
| Is Organization Subpart | Y |
| Parent Organization Name | WEST LOUISIANA HEALTH SERVICES, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | MD.09850R | LA | Allopathic & Osteopathic Physicians |
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
LA | Ambulatory Health Care Facilities |
| Street Address |
600 S PINE ST |
| City | DERIDDER |
| State | LA |
| Zip Code | 70634-4942 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831193499 | Hospital Service District No 2 of Parish of Beauregard State of La | General Acute Care Hospital | 600 S Pine St, Deridder, LA 70634-4942 | 2005-06-10 |
| 1780203000 | James Christian Armetta | Speech-Language Pathologist | 600 S Pine St, Deridder, LA 70634-4942 | 2020-04-16 |
| 1164985495 | West Louisiana Health Services Inc | Physical Therapist | 600 S Pine St, Deridder, LA 70634-4942 | 2019-04-12 |
| 1083111678 | Anna Reuber | Nurse Practitioner | 600 S Pine St, Deridder, LA 70634-4942 | 2018-04-10 |
| 1972019529 | Alexis J Amato | Specialist/Technologist | 600 S Pine St, Deridder, LA 70634-4942 | 2017-12-19 |
| 1316308927 | Kallie Hess | Nurse Practitioner | 600 S Pine St, Deridder, LA 70634-4942 | 2016-03-09 |
| 1972906758 | Concord Medical Group, Pllc | Hospitalist | 600 S Pine St, Deridder, LA 70634-4942 | 2014-10-07 |
| 1710226790 | Beauregard Physician Services LLC | Physician Assistant | 600 S Pine St, Deridder, LA 70634-4942 | 2013-02-11 |
| 1295082568 | Amanda Leigh Harrell | Registered Nurse | 600 S Pine St, Deridder, LA 70634-4942 | 2012-08-06 |
| 1497034185 | Deborah Michelle Thompson | Nurse Practitioner | 600 S Pine St, Deridder, LA 70634-4942 | 2011-08-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861016164 | Just Health | Clinic/Center | 411 Bolivar Bishop Dr, Deridder, LA 70634 | 2020-06-02 |
| 1477193183 | Stacey Marie Legros | Occupational Therapy Assistant | 19503 Highway 171, Deridder, LA 70634 | 2020-01-10 |
| 1487296588 | Imperial Health LLP | Internal Medicine | 200 W 5th Street, Deridder, LA 70634 | 2019-10-10 |
| 1902367568 | Residential Therapy Solutions, LLC | Physical Therapist | 19503 Hwy 171, Deridder, LA 70634 | 2019-03-27 |
| 1023583044 | Calcasieu Urgent Care LLC | Clinic/Center | 1017 N Pine Street, Deridder, LA 70634 | 2018-10-05 |
| 1235638222 | Melanie Welch, Fnp, LLC | Nurse Practitioner | 1420 Blankenship Dr., Deridder, LA 70634 | 2018-02-06 |
| 1265976617 | Jennifer Dianne Midgett | Nurse Practitioner | 2581 Highway 190 W, Deridder, LA 70634 | 2016-12-05 |
| 1821419334 | Beauregard Hematolog & Oncology | Internal Medicine | 301 S. Washington St., Ste B, Deridder, LA 70634 | 2013-12-31 |
| 1982835013 | Kathern Sue Hollifield | Physical Therapist | 309 S. Washington St., Beauregard Physical Therapy Clinic Inc, Deridder, LA 70634 | 2009-08-06 |
| 1750541777 | Tracy Winkley | Physical Therapist | 1744 Ball Rd, Deridder, LA 70634 | 2008-06-12 |
| Find all providers in zip 70634 | ||||
| Taxonomy Code | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063877504 | Renew Podiatry Footcare and Aesthetics Medspa LLC | Clinic/Center | 7501 Trapier Ave, New Orleans, LA 70127-1639 | 2015-12-29 |
| 1669619797 | Ultimate Foot Care LLC | Clinic/Center | 3224 St Claude Avenue, New Orleans, LA 70117 | 2009-01-12 |
| 1194982256 | Elizabeth S. Hawkins Dpm | Clinic/Center | 7423 Picardy Ave, Suite B, Baton Rouge, LA 70808-4362 | 2008-05-16 |
| 1073576823 | Pointe Coupee Better Access Community Healthcare | Clinic/Center | 230 Roberts Drive, Suite C, New Roads, LA 70760 | 2006-04-11 |
| 1093196503 | Robertson Foot and Ankle | Clinic/Center | 1477 Louisiana Ave, Ste 101, New Orleans, LA 70115-3540 | 2015-06-11 |
| 1992122642 | Southern Podiatry Clinic LLC | Clinic/Center | 537 Kentucky Ave Ste B, Bogalusa, LA 70427-3913 | 2014-03-19 |
| 1891054110 | Dr. Warren H. Johnson, Podiatrist, PC | Clinic/Center | 6305 Elysian Fields Ave, Suite 204, New Orleans, LA 70122-4245 | 2012-05-07 |
| 1194083220 | Foot Clinic of Louisiana Inc | Clinic/Center | 2000 Audubon Ave, Suite C-1, Thibodaux, LA 70301-5075 | 2012-04-26 |
| 1235464546 | Crescent City Surgery, LLC | Clinic/Center | 7311 Downman Rd, New Orleans, LA 70126-1213 | 2009-10-05 |
| 1134357619 | Foot Pain Clinic, LLC | Clinic/Center | 3851 S Sherwood Forest Blvd, Ste. 360, Baton Rouge, LA 70816-4361 | 2009-06-23 |
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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.