Clinics of the Southeast LLC

PAC ID

6709116239The PECOS associate control ID: one enrolled organization, which may hold several NPIs

Provider type

Part A Provider - Rural Health Clinic, Part B Supplier - Clinic/Group Practice

Enrolled in

LA

Enrollments

3

Group size

3 cliniciansAs Care Compare reports it

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice locations

4In 1 place

Enrollment records 3

These NPI records belong to the same enrolled organization. Each has its own page.

• Clinics of the Southeast LLC

  dba Bogalusa Family Medicine & Behavioral Health

  • Rural Health Clinic/Center
  • Bogalusa, LA
  • NPI 1053082743
• Clinics of the Southeast LLC

  dba Bogalusa Pediatric Clinic

  • Rural Health Clinic/Center
  • Bogalusa, LA
  • NPI 1053979815

Clinicians who reassign their Medicare benefits to this group (5) or whom Care Compare lists as members (3).

• Anna Axum, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bogalusa, LA
  • NPI 1477490209
• Kimberly Dawn Cagle, FNP

  • Family Nurse Practitioner
  • Bogalusa, LA
  • NPI 1790450773
• Anthony Jude Palazzo, M.D.

  • Pediatric Adolescent Medicine Physician
  • Bogalusa, LA
  • NPI 1063457554
• Heather Johnson Palazzo, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Mandeville, LA
  • NPI 1114322146
• Robin Richardson, LCSW

  • Clinical Social Worker
  • Bogalusa, LA
  • NPI 1265574958
• Ciji Deyuana Wallace, RN-FNP

  • Family Nurse Practitioner
  • Bogalusa, LA
  • NPI 1487455036
• Monica Vercher Wildebrandt, APRN

  • Family Nurse Practitioner
  • Slidell, LA
  • NPI 1306968540

• Medicare Fee-For-Service Public Provider Enrollment: the enrollments, PAC ID, practice locations and benefit reassignments.
• Care Compare Doctors and Clinicians: group membership, group size and the name CMS shows patients.
• NPPES NPI Registry: the names and addresses of the NPIs above.