NPIMap

Organization Active NPI

Louisiana Family Medicine Clinic, Inc.

  • Non-Pharmacy Dispensing Site
  • Jonesboro, LA
National Provider Identifier
1083094007
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
LOUISIANA FAMILY MEDICINE CLINIC, INC.
Practice address
103 Watts St
Jonesboro, LA 71251-2053
Phone
(318) 259-1569
Fax
(318) 259-8523
NPI assigned
Jun 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Authorized official

Name
Dirk Rainwater, MDNPI 1043286230
Title
Owner
Phone
(318) 259-1569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

103 Watts St
Jonesboro, LA 71251-2053

Mailing address

103 Watts St
Jonesboro, LA 71251-2053
Phone (318) 259-1569

National Provider Directory

National Provider Directory
Tax ID family
La Fam Medc Clin2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

103 Watts St
Jonesboro, LA 71251
Phone (318) 259-1569

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433376000000",
    "number": "1083094007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WATTS ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512053",
            "telephone_number": "318-259-1569",
            "fax_number": "318-259-8523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WATTS ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712512053",
            "telephone_number": "318-259-1569",
            "fax_number": "318-259-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA FAMILY MEDICINE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2015-06-04",
        "status": "A",
        "authorized_official_last_name": "RAINWATER",
        "authorized_official_first_name": "DIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-259-1569",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.