| Northeast Louisiana Health Center | |
|
256 Highway 3048 Rayville LA 71269-3624 | |
| (318) 728-2046 | |
| (318) 728-9371 |
| Full Name | Northeast Louisiana Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 256 Highway 3048, Rayville, Louisiana |
| Authorized Official Name and Position | James Barrett (ADMINISTRATOR) |
| Authorized Official Contact | 3187282046 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Louisiana Health Center 256 Highway 3048 Rayville LA 71269-3624 Ph: (318) 728-2046 | Northeast Louisiana Health Center 256 Highway 3048 Rayville LA 71269-3624 Ph: (318) 728-2046 |
| NPI Number | 1043368392 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 2163481599 |
|---|---|
| Medicare Enrollment ID | O20041011000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043368392 | NPI | - | NPPES |
| 1797146 | Medicaid | LA | |
| 1945081 | Medicaid | LA |
| Provider Name | Kasey Baldwin Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942514385 PECOS PAC ID: 3072707272 Enrollment ID: I20101102000320 |
| Provider Name | Angela C Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821352535 PECOS PAC ID: 8022274570 Enrollment ID: I20120727000192 |
| Provider Name | Kyle B Bruyninckx |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972770378 PECOS PAC ID: 2163670688 Enrollment ID: I20120907000037 |
| Provider Name | Matthew D Prine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558650861 PECOS PAC ID: 0840424248 Enrollment ID: I20131017000678 |
| Provider Name | Kevin M Carlisle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326337635 PECOS PAC ID: 0042447443 Enrollment ID: I20131210001270 |
| Provider Name | Leslie H Oglesby |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407113756 PECOS PAC ID: 0446569768 Enrollment ID: I20151027001142 |
| Provider Name | Ariel D Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710414719 PECOS PAC ID: 7315216553 Enrollment ID: I20170703001504 |
| Provider Name | Lauren S Bonnette |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538450317 PECOS PAC ID: 3375843220 Enrollment ID: I20170711002069 |
| Provider Name | Evelyn W Branch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780882787 PECOS PAC ID: 0446592588 Enrollment ID: I20190422000869 |
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