| Innis Community Health Center, Inc | |
|
6450 Louisiana Highway 1 Batchelor LA 70715-6450 | |
| (225) 492-3775 | |
| (225) 492-3782 |
| Full Name | Innis Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6450 Louisiana Highway 1, Batchelor, Louisiana |
| Authorized Official Name and Position | Cindy G Peavy (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2254923775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Innis Community Health Center, Inc 6450 Louisiana Highway 1 Batchelor LA 70715-6450 Ph: (225) 492-3775 | Innis Community Health Center, Inc 6450 Louisiana Highway 1 Batchelor LA 70715-6450 Ph: (225) 492-3775 |
| NPI Number | 1205858388 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 11/18/2021 |
| Medicare PECOS PAC ID | 9931130358 |
|---|---|
| Medicare Enrollment ID | O20050825000691 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205858388 | NPI | - | NPPES |
| 1441961 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Lawrence C Carter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366497596 PECOS PAC ID: 1153399845 Enrollment ID: I20040921000344 |
| Provider Name | Latasha Johnigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467781757 PECOS PAC ID: 4688702848 Enrollment ID: I20100507000590 |
| Provider Name | Michael P Ramagos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942524970 PECOS PAC ID: 7012165699 Enrollment ID: I20120925000073 |
| Provider Name | Ahlecia N Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467874719 PECOS PAC ID: 8224354923 Enrollment ID: I20150223001433 |
| Provider Name | Monitetra King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972602662 PECOS PAC ID: 3274835905 Enrollment ID: I20160112001295 |
| Provider Name | Jeremy B Courville |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114377124 PECOS PAC ID: 2567756745 Enrollment ID: I20160810002639 |
| Provider Name | Caroline Stagg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548751415 PECOS PAC ID: 1658628649 Enrollment ID: I20180723000860 |
| Provider Name | Alvin J Laprarie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316612856 PECOS PAC ID: 9335546662 Enrollment ID: I20210929000236 |
| Provider Name | Sarah S Webre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306563366 PECOS PAC ID: 4082086665 Enrollment ID: I20230404002136 |
| Provider Name | Katelyn A Dupre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609558055 PECOS PAC ID: 0840654042 Enrollment ID: I20230906002802 |
| Provider Name | Danielle Gros |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275140733 PECOS PAC ID: 1759731300 Enrollment ID: I20231222002421 |
| Provider Name | Ashley Bayoumi |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629469739 PECOS PAC ID: 6608226477 Enrollment ID: I20240223002226 |
| Provider Name | Deanderia Gremillion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497125462 PECOS PAC ID: 1759727043 Enrollment ID: I20240308002103 |
| Provider Name | Melinda Levi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902678733 PECOS PAC ID: 6103368717 Enrollment ID: I20240611003086 |
| Provider Name | Kathleen Shaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477080927 PECOS PAC ID: 2466996012 Enrollment ID: I20240708000243 |
| Provider Name | Kayce Domingue |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1205293768 PECOS PAC ID: 5092245738 Enrollment ID: I20250210002776 |
| Provider Name | Mary Meaux |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922802594 PECOS PAC ID: 0547787376 Enrollment ID: I20250506001427 |
| Provider Name | Brooke Chauvin Otremba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043998156 PECOS PAC ID: 4385096726 Enrollment ID: I20250516001253 |
Innis Community Health Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4739 La Highway 419, Batchelor, LA 70715 Phone: 225-492-3775 Fax: 225-492-3782 |