Active NPI
Family Wellness and Health Care of Louisiana LLC
- Family Nurse Practitioner
- Denham Springs, LA
National Provider Identifier
1063199586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- FAMILY WELLNESS AND HEALTH CARE OF LOUISIANA LLC
- Practice address
- 315 Veterans Blvd
Denham Springs, LA 70726-4722 - Phone
- (225) 667-5110
- Fax
- (833) 357-1731
- NPI assigned
- Jun 28, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hilary L Hicks, FNP
- Title
- Owner
- Phone
- (225) 603-4249
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
315 Veterans Blvd
Denham Springs, LA 70726-4722
Mailing address
315 Veterans Blvd
Denham Springs, LA 70726-4722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240306002611 | LA | Part B Supplier - Clinic/Group Practice | 7911366752 |
Receives reassigned benefits from 2 practitioners Practice locations: Denham Springs, LA |
National Provider Directory
National Provider DirectoryLocations
315 Veterans Blvd
Denham Springs, LA 70726
Phone (225) 667-5110
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Denham Springs, LA
- NPI 1487412003
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1687910400000",
"number": "1063199586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 VETERANS BLVD",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707264722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 VETERANS BLVD",
"city": "DENHAM SPRINGS",
"state": "LA",
"postal_code": "707264722",
"telephone_number": "225-667-5110",
"fax_number": "833-357-1731"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY WELLNESS AND HEALTH CARE OF LOUISIANA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-28",
"last_updated": "2023-06-28",
"certification_date": "2023-06-28",
"status": "A",
"authorized_official_last_name": "HICKS",
"authorized_official_first_name": "HILARY",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "225-603-4249",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denham Springs, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.