DESOTO HEALTHCARE CENTER INC. (NPI# 1811209232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811209232 |
| Entity Type | Organization |
| Organization Name | DESOTO HEALTHCARE CENTER INC. |
| Practice Address |
938 Louise St Mansfield LA 71052 |
| Mailing Address |
Po Box 1384 Mansfield LA 71052-1384 |
| Practice Telephone | 3188711633 |
| Practice Fax Number | 3188711677 |
| Mailing Telephone | 3188711633 |
| Mailing Fax Number | 3188711677 |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2011-12-23 |
| Authorized Official Name | MS. CONNIE B GANNON (FAMILY NURSE PRACTITIONER) |
| Authorized Official Telephone | 3188711633 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
1487481 | LA | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 1996971 | LA | Allopathic & Osteopathic Physicians |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
03124 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
020173 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | MD199935 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2117629 | 05 |
| Street Address |
938 LOUISE ST |
| City | MANSFIELD |
| State | LA |
| Zip Code | 71052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689186421 | Bridgette Williams | Counselor | 419 Washington Street, Mansfield, LA 71052 | 2017-11-02 |
| 1922527217 | Cherlyndria Wyatt | Counselor | 108 Hope St, Mansfield, LA 71052 | 2017-09-18 |
| 1619342433 | Stanley Cunningham | Counselor | 125 Canary Lane, Mansfield, LA 71052 | 2015-12-04 |
| 1578936480 | Comiseia Jones | Counselor | 2102 N Park Ave, Mansfield, LA 71052 | 2015-11-02 |
| 1932571023 | Elichia Bennett | Counselor | 584 Antioch Rd, Mansfield, LA 71052 | 2015-10-28 |
| 1912378597 | Angela Mcintyre | Case Manager/Care Coordinator | 162 Division St, Mansfield, LA 71052 | 2015-10-08 |
| 1144690645 | Edwina Elrod Eley | Nurse Practitioner | 7356 Highway 509, Mansfield, LA 71052 | 2015-09-28 |
| 1760746176 | Amy Melton Robbins | Occupational Therapist | 558 Turner Robbins Rd, Mansfield, LA 71052 | 2012-06-29 |
| 1174786263 | Frances Jackson | Speech-Language Pathologist | 508 Rea Street, Mansfield, LA 71052 | 2008-07-08 |
| 1255521183 | Superior Hospice of Northwest Louisiana, LLC | Hospice Care, Community Based | 511 Jenkins St., Suite B, Mansfield, LA 71052 | 2007-07-26 |
| Find all providers in zip 71052 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351474 | Rudo P Madondo-gwitira | Family Medicine | 4201 Palmer Dr, Mansfield, TX 76063-3432 | 2020-09-23 |
| 1174937916 | Kyle Ungvarsky | Family Medicine | 416 South Main Street, Mansfield, PA 16933 | 2014-06-19 |
| 1992143549 | Philip U Ramirez | Family Medicine | 1601 E Debbie Ln Ste 2109, Mansfield, TX 76063-4130 | 2013-06-05 |
| 1396066171 | Jeffrey Urieto | Family Medicine | 1776 North Us 287, Suite 220, Mansfield, TX 76063 | 2010-06-16 |
| 1184882813 | Doyle Fairchild Gallman Jr. | Family Medicine | 2360 Highway 157 N, Mansfield, TX 76063-7540 | 2008-05-29 |
| 1699958579 | Pannaben H Nangha | Family Medicine | 221 Regency Pkwy, Suite 125, Mansfield, TX 76063-5165 | 2007-12-13 |
| 1992905376 | Joseph M Kim | Family Medicine | 1718 Us 287 Frontage Rd., Suite 200, Mansfield, TX 76063 | 2007-07-23 |
| 1487861738 | Erica L Sails | Family Medicine | 1757 Broad Park Cir N Ste 201, Mansfield, TX 76063-7839 | 2007-05-17 |
| 1578618492 | Doyle F Gallman Do Pa | Family Medicine | 2360 Fm 157 N, Mansfield, TX 76063-7540 | 2007-01-23 |
| 1689730996 | Patricia Charlene Laurie Brock | Family Medicine | 1420 Parkside Dr, Mansfield, TX 76063-8618 | 2006-12-29 |
| Find all providers in MANSFIELD | ||||
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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.