NPIMap

Organization Active NPI

Innis Community Health Center, Inc

Doing business as New Roads Community Health Center

  • Federally Qualified Health Center (FQHC)
  • New Roads, LA
National Provider Identifier
1053841072
Registry record updated Sep 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INNIS COMMUNITY HEALTH CENTER, INC
Doing business as
New Roads Community Health Center
Practice address
230 Roberts Dr Ste H
New Roads, LA 70760-2661
Phone
(225) 618-7800
Fax
(225) 238-8330
NPI assigned
Jun 13, 2017
Last updated
Sep 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
INNIS COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2026

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

Authorized official

Name
Cindy Griffin Peavy
Title
Executive Director
Phone
(225) 618-7161

Specialties & licenses 1

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

Addresses

Primary practice location

230 Roberts Dr Ste H
New Roads, LA 70760-2661

Mailing address

112 Telly St
New Roads, LA 70760-2521
Phone (225) 618-5015

Other identifiers 1

IdentifierTypeStateIssuer
2449826MedicaidLA

Other names 2

  • New Roads Community Health Center Doing business as
  • Arbor Family Health Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050825000691 LA Part B Supplier - Clinic/Group Practice 9931130358 Receives reassigned benefits from 27 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Roads, LA; Maringouin, LA; Livonia, LA; Batchelor, LA
O20170914000078 LA Part A Provider - Federally Qualified Health Center (FQHC) 9931130358 Practice locations: New Roads, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1053841072. Details of each certification follow.

Federally qualified health center certification: CCN 191973

Legal name
INNIS COMMUNITY HEALTH CENTER, INC
Doing business as
NEW ROADS COMMUNITY HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 11, 2017
Last certification
Jul 11, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationProprietary
Incorporated
Jun 1, 2001 in LA
Enrollment address
230 Roberts Dr
Ste H
New Roads, LA 70760-2661

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2132654New Roads Community Health Center230 Roberts Dr, Ste H, New Roads, LA 70760Provider-performed microscopyJun 25, 2027

National Provider Directory

National Provider Directory
Part of
Livonia Comm Health Ctr

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Marilu Corona Individual Corporate OfficerBoard Member Apr 1, 2019
Dania Tolliver Individual Corporate OfficerBoard Member Nov 1, 2021
Jeanine Thibodeaux Individual Corporate DirectorBoard Member Jun 1, 2001
Beulah Epps Individual Corporate DirectorBoard Member Jun 1, 2001
Irma Smith Individual Corporate DirectorBoard Member Jan 1, 2010
Gary Scronce Individual Corporate OfficerBoard Member Nov 1, 2021
Cindy G Peavy Individual W-2 Managing EmployeeCeo Jun 1, 2013
Frances Sagona Individual Corporate OfficerBoard Member Nov 1, 2021
Garrett Lejeune Individual Corporate DirectorBoard Member Jan 1, 2011
Rachel Nelson Individual Corporate OfficerDirections of Operations Oct 1, 2002
W-2 Managing EmployeeDirector of Operations Oct 1, 2002
Chad Olinde Individual Corporate DirectorBoard Member Jun 1, 2001
Reginald Franklin Individual Corporate DirectorBoard Member Jan 1, 2009

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 6

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": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790553600000",
    "number": "1053841072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TELLY ST",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602521",
            "telephone_number": "225-618-5015",
            "fax_number": "225-442-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ROBERTS DR STE H",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602661",
            "telephone_number": "225-618-7800",
            "fax_number": "225-238-8330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2017-06-13",
        "last_updated": "2026-09-28",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "PEAVY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "GRIFFIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-618-7161"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2449826",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Roads Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "New Roads Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arbor Family Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New Roads, LA

Sources for this page

Verify at the official NPI Registry.