St Gabriel Health Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ST GABRIEL HEALTH CLINIC INC

Doing business as

St. Gabriel Healt H Clinic, Inc.

Practice address

5760 Monticello Dr
Saint Gabriel, LA 70776-4412

Phone

(225) 642-9676

Fax

(225) 642-9696

NPI assigned

Dec 6, 2006

Last updated

May 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ashley T. Levy

Title

Ceo

Phone

(225) 642-9676

Specialties & licenses 2

Addresses

Other identifiers 8

Other names 1

• ST. GABRIEL HEALT H CLINIC, INC. Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• St Gabriel Health Clinic Inc

  dba Gardere Center for Primary Care

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1962777136

  9830008416

  Same PAC ID

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

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.

• Cristen Morris Crain, NP

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1598190837
  Medicare reassignment NPD
• Chillena Edwards, FNP

  • Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1073072310
  Medicare reassignment NPD
• April Latasha Jackson, FNP

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1942787684
  Medicare reassignment NPD
• Shirley Freeman Wade, FNP-C

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1831250166
  Medicare reassignment NPD
• Monica Williams Weiss, APRN,FNP

  • Family Nurse Practitioner
  • Clinton, LA
  • NPI 1821351321
  Medicare reassignment NPD
• Tina Leslie-Watson, FNP-C

  • Family Nurse Practitioner
  • Geismar, LA
  • NPI 1215397336
  NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1093874000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 209",
            "city": "SAINT GABRIEL",
            "state": "LA",
            "postal_code": "707760209",
            "telephone_number": "225-642-9676",
            "fax_number": "225-642-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5760 MONTICELLO DR",
            "city": "SAINT GABRIEL",
            "state": "LA",
            "postal_code": "707764412",
            "telephone_number": "225-642-9676",
            "fax_number": "225-642-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST GABRIEL HEALTH CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-642-9676",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2191217",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1944114",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2503146",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2156161",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457680",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2503341",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093874000",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2422430",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ST. GABRIEL HEALT H CLINIC, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Anne Park, ACNP-BC
• Johnny Francois Prejean Jr.
• Pamela B. Ross, WHNP
• Norma Seguin
• Polly Bush Smith, FNP-C
• Audrey Bon Stansbury, CPNP
• Diana W. Ware, MS, PLPC
• Brittany Burdsall West, OT
• Joshua White
• Lisa Zobrist Wilson, APRN-C

• Family Medicine Physician in Saint Gabriel, LA
• Providers in Saint Gabriel, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.