CHRISTUS HEALTH CENTRAL LOUISIANA (NPI# 1790767267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790767267 |
| Entity Type | Organization |
| Organization Name | CHRISTUS HEALTH CENTRAL LOUISIANA |
| Other Organization Name | CHRISTUS COUSHATTA DENTAL CLINIC |
| Practice Address |
1635 Marvel St Coushatta LA 71019-9022 |
| Practice Telephone | 3189322207 |
| Practice Fax Number | 3189322186 |
| Mailing Telephone | 3189322207 |
| Mailing Fax Number | 3189322186 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2008-04-07 |
| Authorized Official Name | MRS. KAREN MIXON (CEO) |
| Authorized Official Telephone | 3189322207 |
| Is Organization Subpart | Y |
| Parent Organization Name | CHRISTUS HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
551RHC-1 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1880795 | 05 |
| Other Name | Type Code |
|---|---|
| CHRISTUS Coushatta Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033643523 | Christus Health Central Louisiana | Clinic/Center | 415 St. Clair Road, Suite B, Boyce, LA 71409 | 2017-04-12 |
| 1164687307 | Christus Health Central Louisiana | Clinic/Center | 132 Cherry St, Provencal, LA 71468 | 2008-07-28 |
| 1609031962 | Christus Health Central Louisiana | Clinic/Center | 10800 Hwy 120, Marthaville, LA 71450 | 2008-07-25 |
| 1356462782 | Christus Health Central Louisiana | Clinic/Center | 200 Hwy 3110, Natchitoches, LA 71457 | 2007-04-03 |
| 1093836421 | Christus Health Central Louisiana | Clinic/Center | 1207 Tioga Rd, Pineville, LA 71405-3989 | 2007-04-03 |
| 1902927338 | Christus Health Central Louisiana | Clinic/Center | 7305 Highway 9, Campti, LA 71411-4137 | 2007-04-03 |
| 1376664706 | Christus Health Central Louisiana | Clinic/Center | 1414 7th Avenue, Glenmora, LA 71433 | 2007-04-03 |
| 1023139458 | Christus Health Central Louisiana | Clinic/Center | 207 Griffith St, Pineville, LA 71360-5267 | 2007-04-03 |
| 1730200163 | Christus Health Central Louisiana | Clinic/Center | 501 Edgewood Dr, Pineville, LA 71360-4524 | 2007-04-03 |
| 1285755611 | Christus Health Central Louisiana | Clinic/Center | 715 Highway 1207, Deville, LA 71328-8505 | 2007-04-03 |
| Street Address |
1635 MARVEL ST |
| City | COUSHATTA |
| State | LA |
| Zip Code | 71019-9022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326043753 | Lavora Chevon Babers-wilson | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019 | 2005-06-13 |
| 1013575695 | J.l. Nurse Practitioner, LLC | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2019-05-30 |
| 1982177556 | Jennifer L Perry | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2019-01-07 |
| 1417494758 | Christus Health Central Louisiana | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2017-01-25 |
| 1003365636 | Christopher Troy Bamburg | Physician Assistant | 1635 Marvel St, Coushatta, LA 71019-9022 | 2016-09-23 |
| 1073069589 | Misti Lelong Morgan | Nurse Practitioner | 1635 Marvel St, Coushatta, LA 71019-9022 | 2016-08-26 |
| 1427480680 | Coushatta Er Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2013-07-30 |
| 1770719668 | Shannon Gammill Berry | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-06-05 |
| 1245466408 | Joshua Ray Cason | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-06-02 |
| 1689817512 | Western La Emergency Physicians | Emergency Medicine | 1635 Marvel St, Coushatta, LA 71019-9022 | 2009-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255898763 | Saint Mark Hospice and Palliative Care LLC | Hospice Care, Community Based | Saint Mark Hospice and Palliative Care LLC, 298 Army Rd, Coushatta, LA 71019 | 2019-02-21 |
| 1750824900 | Ruby Braxton | Counselor | 936 E. Carroll Street, Coushatta, LA 71019 | 2016-11-21 |
| 1447621222 | Ranette Smith | Counselor | 1414 Leigh Street, Coushatta, LA 71019 | 2015-10-19 |
| 1205157237 | Red River Parish Police Jury | Ambulance | 525 Rush Street, Coushatta, LA 71019 | 2010-06-14 |
| 1255566857 | Medcore Specialty Pharmacy | Pharmacy | 1435 E. Carroll St., Suite B, Coushatta, LA 71019 | 2009-05-27 |
| 1437346186 | Specialty Rehabilitation Hospital, L.L.C. | Rehabilitation Hospital | 1110 Ringgold Avenue, Suite B, Coushatta, LA 71019 | 2007-09-26 |
| 1679785976 | Red River Council On Aging, Inc. | Adult Companion | 1825 Front Street, Coushatta, LA 71019 | 2007-05-07 |
| 1699805515 | Red River Association for Retarded Citizens Inc | Day Training, Developmentally Disabled Services | 1908 Hwy 71 S, Coushatta, LA 71019 | 2007-03-07 |
| 1629108386 | Red River Association for Retarded Citizens Inc | Day Training, Developmentally Disabled Services | 1908 Hwy 71 South, Coushatta, LA 71019 | 2007-03-06 |
| 1245366251 | The Will of God Ministries Outreach Program | Preferred Provider Organization | 1113 Caliope Street, Coushatta, LA 71019 | 2007-02-26 |
| Find all providers in zip 71019 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082952 | Jimani Blackwell Dds LLC | Clinic/Center | 8015 Maple St, New Orleans, LA 70118-2738 | 2020-10-28 |
| 1578185096 | Dr. Raymond Poirrier Dds LLC | Clinic/Center | 1968 N Highway 190 Ste 11a, Covington, LA 70433-5158 | 2020-05-07 |
| 1851912711 | Covington Empower Orthodontics LLC - Dr Timothy M Poyadou Jr | Clinic/Center | 100 Tyler Sq Ste 4, Covington, LA 70433-3060 | 2020-05-01 |
| 1699314799 | Peach Tree Dental West Monroe, LLC | Clinic/Center | 3422 Cypress St, West Monroe, LA 71291-7310 | 2020-01-06 |
| 1538706015 | Exceptional Dental of Uptown, LLC | Clinic/Center | 5300 Tchoupitoulas St Ste F4, New Orleans, LA 70115-1963 | 2019-12-04 |
| 1447897186 | Affordable Smiles of Hammond, LLC | Clinic/Center | 2804 W Thomas St, Hammond, LA 70401-2841 | 2019-12-02 |
| 1528615887 | Benjamin A. Beach Dds and Ross H. Dies Dds Midcity, LLC | Clinic/Center | 8510 Line Ave Ste A, Shreveport, LA 71106-6119 | 2019-08-21 |
| 1295380418 | W. J. Dudley Denture Consultants | Clinic/Center | 4354 Pines Rd, Shreveport, LA 71119-7738 | 2019-08-05 |
| 1689226946 | Silver Lining Dentistry & Co. | Clinic/Center | 2305 West Esplanade Suit U, Kenner, LA 70065 | 2019-07-16 |
| 1790337632 | West Baton Rouge Dental Associates, LLC | Clinic/Center | 6572 Hwy 1 South, Addis, LA 70710 | 2019-07-11 |
| 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.