Premier Family Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

PREMIER FAMILY CLINIC

Practice address

102 Office Park Dr.
Minden, LA 71055

Phone

(318) 377-2885

Fax

(318) 377-0096

NPI assigned

Jul 24, 2019

Organization subpart

No

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

Authorized official

Name

Mrs. Stephanie Williams, FNP-CNPI 1023200060

Title

Owner

Phone

(318) 377-2885

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie K Williams, FNP-C

  • Family Nurse Practitioner
  • Minden, LA
  • NPI 1023200060
  Medicare reassignment Care Compare group NPD Authorized official
• Allen Ray Mosley, NP

  • Nurse Practitioner
  • Minden, LA
  • NPI 1548573751
  Medicare reassignment Care Compare group NPD
• Emily Elliott Bryce, PA-C

  • Physician Assistant
  • Shreveport, LA
  • NPI 1376264895
  Medicare reassignment Care Compare group
• Jacquelyn Kibodeaux White, M.D.

  • Emergency Medicine Physician
  • Ruston, LA
  • NPI 1629186812
  NPD (past)

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563926400000",
    "number": "1003469479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 OFFICE PARK DR.",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "71055",
            "telephone_number": "318-377-2885",
            "fax_number": "318-377-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 OFFICE PARK DR.",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "71055",
            "telephone_number": "318-377-2885",
            "fax_number": "318-377-0096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2019-07-24",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-377-2885",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Pistorius, M.D.
• Michelle Antoinette Pittman, MD
• Herbert Charles Poarch, NURSE PRACTITIONER
• Kimberly Mayo Pool, NP
• Gregory David Powell, CRNA
• Primestar Home Health of Nwla Inc
• Justin Levi Procell, DDS
• Cady Pruitt
• Quest Diagnostics Clinical Laboratories Inc
• Ben H Quinney Jr., M.D.

• Family Nurse Practitioner in Minden, LA
• Providers in Minden, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.