NPIMap

Organization Active NPI

Southwest Louisiana Primary Health Care Center Inc

Doing business as Evangeline Family Medicine Center

  • Federally Qualified Health Center (FQHC)
  • Ville Platte, LA
National Provider Identifier
1003042698
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER INC
Doing business as
Evangeline Family Medicine Center
Practice address
505 E Lincoln Rd
Ville Platte, LA 70586-3514
Phone
(337) 942-3390
Fax
(337) 942-8644
NPI assigned
Jun 9, 2009
Last updated
Oct 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Dodie Lamott, CEO
Title
Chief Executive Officer
Phone
(337) 942-3390

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X LA Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

505 E Lincoln Rd
Ville Platte, LA 70586-3514

Mailing address

8762 Highway 182
Opelousas, LA 70570-5603
Phone (337) 942-3390

Other names 1

  • EVANGELINE FAMILY MEDICINE CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041214000920 LA Part B Supplier - Clinic/Group Practice 8628987682 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ville Platte, LA
O20181130002328 LA Part A Provider - Federally Qualified Health Center (FQHC) 8628987682 Practice locations: Ville Platte, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003042698. Details of each certification follow.

Federally qualified health center certification: CCN 191008

Legal name
SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER, INC
Doing business as
EVANGELINE FAMILY MEDICINE CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 30, 2018
Last certification
Nov 30, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 1, 2013 in LA
Enrollment address
505 E Lincoln Rd
Ville Platte, LA 70586-3514

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
SW Louisiana Primary He10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1800 Louisiana Ave
Lafayette, LA 70501
Phone (337) 232-6787

8762 Highway 182
Opelousas, LA 70570
Phone (337) 942-2005

110 E Lincoln Rd
Ville Platte, LA 70586
Phone (337) 942-3390

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEIHAA

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lonnie Fontenot Individual Corporate DirectorDirector Jun 1, 2013
Josie Frank Individual Corporate DirectorBoard of Directors - Vice President Jun 1, 2013
Dodie J Lamott Individual Corporate OfficerChief Executive Officer Jun 1, 2013
W-2 Managing EmployeeChief Executive Officer Jun 1, 2013
Mary T Guidry Individual Corporate DirectorBoard of Directors - Member Jun 1, 2013
Linda Prudhomme Individual Corporate DirectorBoard of Directors - Secretary Jun 1, 2013
Patrick J Leday Individual Corporate DirectorBoard of Directors - President Jun 1, 2013
Sarah Carriere Individual Corporate DirectorBoard of Directors - Treasure Jun 1, 2013
Janel Simien Individual Corporate DirectorBoard of Directors - Member Jun 1, 2013

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southwest Louisiana Primary Health Care CenterOpelousas, LA, CCN 191817 Federally qualified health center Operational/Managerial Control Feb 1, 1993

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540771200000",
    "number": "1003042698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8762 HIGHWAY 182",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705705603",
            "telephone_number": "337-942-3390",
            "fax_number": "337-942-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E LINCOLN RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863514",
            "telephone_number": "337-942-3390",
            "fax_number": "337-942-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-09",
        "last_updated": "2018-10-29",
        "status": "A",
        "authorized_official_last_name": "LAMOTT",
        "authorized_official_first_name": "DODIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "337-942-3390",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "LA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EVANGELINE FAMILY MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ville Platte, LA

Sources for this page

Verify at the official NPI Registry.