| Homer Memorial Hospital | |
|
620 East College St. Homer LA 71040 | |
| (318) 927-2024 | |
| (318) 927-9212 |
| Full Name | Homer Memorial Hospital |
|---|---|
| Speciality | Emergency Medicine |
| Location | 620 East College St., Homer, Louisiana |
| Authorized Official Name and Position | Tina Haynes (CEO) |
| Authorized Official Contact | 3189272024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homer Memorial Hospital Po Box 809 620 E College St. Homer LA 71040 Ph: (318) 927-2024 | Homer Memorial Hospital 620 East College St. Homer LA 71040 Ph: (318) 927-2024 |
| NPI Number | 1609066646 |
|---|---|
| Provider Enumeration Date | 07/26/2007 |
| Last Update Date | 02/27/2025 |
| Medicare PECOS PAC ID | 1456322692 |
|---|---|
| Medicare Enrollment ID | O20040803000291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609066646 | NPI | - | NPPES |
| 1705802 | Medicaid | LA | |
| 04802 | Other | LA | BLUE CROSS |
| 1799645 | Medicaid | LA |
| Provider Name | Mark B Holder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861452260 PECOS PAC ID: 1658278486 Enrollment ID: I20031218000413 |
| Provider Name | Jose Gonzalo Zavaleta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760566376 PECOS PAC ID: 0345236980 Enrollment ID: I20040421000467 |
| Provider Name | Ugochukwu Ike |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578517652 PECOS PAC ID: 7618965732 Enrollment ID: I20040505001222 |
| Provider Name | James M Belue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871520023 PECOS PAC ID: 7719977263 Enrollment ID: I20040517000010 |
| Provider Name | Henry J Kaufman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477510535 PECOS PAC ID: 9537144456 Enrollment ID: I20040623000819 |
| Provider Name | Daniel E Crook |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396801452 PECOS PAC ID: 3072599869 Enrollment ID: I20040624000473 |
| Provider Name | Debra J Baggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023113784 PECOS PAC ID: 6305817545 Enrollment ID: I20040803000259 |
| Provider Name | Menoni I Ize-iyamu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538133210 PECOS PAC ID: 6709850050 Enrollment ID: I20040823000698 |
| Provider Name | Samuel K Abshire |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407883820 PECOS PAC ID: 6406817063 Enrollment ID: I20041106000025 |
| Provider Name | Clint C Butler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306876826 PECOS PAC ID: 2567423155 Enrollment ID: I20041106000030 |
| Provider Name | Shannon D Spigener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669441671 PECOS PAC ID: 4082679311 Enrollment ID: I20041129000011 |
| Provider Name | Mark A St Cyr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184678997 PECOS PAC ID: 9335197748 Enrollment ID: I20050112000006 |
| Provider Name | Robert R Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487610879 PECOS PAC ID: 6204888720 Enrollment ID: I20050214000101 |
| Provider Name | Camille T Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013949213 PECOS PAC ID: 0345273090 Enrollment ID: I20050914000342 |
| Provider Name | Deborah Fletcher |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699777011 PECOS PAC ID: 9830122597 Enrollment ID: I20051130000262 |
| Provider Name | Helen D Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831137579 PECOS PAC ID: 6901812411 Enrollment ID: I20060221000546 |
| Provider Name | Carol S Twyman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073579314 PECOS PAC ID: 5496859027 Enrollment ID: I20070409000357 |
| Provider Name | Kevin D Chiasson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316147119 PECOS PAC ID: 0840382776 Enrollment ID: I20070823000647 |
| Provider Name | Harold David Tyler |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1629064019 PECOS PAC ID: 4587704986 Enrollment ID: I20091216000089 |
| Provider Name | William M Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184735151 PECOS PAC ID: 3072603570 Enrollment ID: I20100301000012 |
| Provider Name | Donald S Haynes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306957386 PECOS PAC ID: 7012069727 Enrollment ID: I20100301000017 |
| Provider Name | Clifton Wales Salmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346205507 PECOS PAC ID: 4486790490 Enrollment ID: I20100726000247 |
| Provider Name | Larry J Haley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114907649 PECOS PAC ID: 4486554763 Enrollment ID: I20101202000521 |
| Provider Name | Matthew W Adkins |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942517008 PECOS PAC ID: 0446448369 Enrollment ID: I20101220000550 |
| Provider Name | Michael J Lewis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366773400 PECOS PAC ID: 0941480719 Enrollment ID: I20110210001012 |
| Provider Name | Michael J Weber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679626097 PECOS PAC ID: 6608976238 Enrollment ID: I20120223000629 |
| Provider Name | Lisa M Faulkenbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518254713 PECOS PAC ID: 6406014166 Enrollment ID: I20120306000734 |
| Provider Name | Nicholas D Adams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497021935 PECOS PAC ID: 9739340555 Enrollment ID: I20120420000566 |
| Provider Name | Megan L Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548506090 PECOS PAC ID: 3072759273 Enrollment ID: I20130412000483 |
| Provider Name | Courtney Nicole Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952784209 PECOS PAC ID: 5092017160 Enrollment ID: I20160106001044 |
| Provider Name | Stella Immanuel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902947120 PECOS PAC ID: 8123067543 Enrollment ID: I20170630001975 |
| Provider Name | Kenneth Lance Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912483132 PECOS PAC ID: 9638427750 Enrollment ID: I20180807001431 |
| Provider Name | Angela Potter Dison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972156040 PECOS PAC ID: 0749612885 Enrollment ID: I20191112001182 |
| Provider Name | Brian Smeby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053585505 PECOS PAC ID: 2860564259 Enrollment ID: I20200508000648 |
| Provider Name | Cara M Permenter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942741376 PECOS PAC ID: 0446524243 Enrollment ID: I20200707001724 |
| Provider Name | Kaleigh Marie Stephenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336764604 PECOS PAC ID: 4486077591 Enrollment ID: I20200708001950 |
| Provider Name | Justin G Gates |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114203635 PECOS PAC ID: 6305010877 Enrollment ID: I20210429001863 |
| Provider Name | Danielle Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255837894 PECOS PAC ID: 6002166881 Enrollment ID: I20210726001768 |
| Provider Name | Angelisa Strayhan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518479815 PECOS PAC ID: 9830593557 Enrollment ID: I20210803001507 |
| Provider Name | Devan R Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487223699 PECOS PAC ID: 6103224282 Enrollment ID: I20211004001444 |
| Provider Name | Jennifer Lynn Sunderland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659948651 PECOS PAC ID: 4486046406 Enrollment ID: I20220124002065 |
| Provider Name | Clay Dean Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730801754 PECOS PAC ID: 1153792908 Enrollment ID: I20230113002639 |
| Provider Name | James M Mccarty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265052088 PECOS PAC ID: 1557736626 Enrollment ID: I20230404001673 |
| Provider Name | Robert T Segraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215963087 PECOS PAC ID: 3971638123 Enrollment ID: I20231218001566 |
| Provider Name | Anna G Braswell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356168132 PECOS PAC ID: 0749714145 Enrollment ID: I20241107001959 |
Family Medical Clinic Of Homer, La Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Morris Cir, Homer, LA 71040 Phone: 318-927-6777 Fax: 318-927-6714 | |
Unconditional Care Behavioral Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 Hwy 79, Homer, LA 71040 Phone: 318-216-5562 | |
Cw Outreach Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4229 Us-79, Homer, LA 71040 Phone: 318-523-4103 | |
Homer Memorial Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 912 W Main St, Homer, LA 71040 Phone: 318-927-3571 | |
Divinity Healthcare Services Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 611 W 2nd St, Homer, LA 71040 Phone: 318-265-4542 Fax: 318-550-4271 | |
Springhill Medical Services, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Morris Circle, Homer, LA 71040 Phone: 318-927-1110 Fax: 318-927-1116 |