NPIMap

Organization Active NPI

Zwolle Medical Clinic

  • Primary Care Clinic/Center
  • Zwolle, LA
National Provider Identifier
1124149307
Registry record updated Aug 22, 2020
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128b(8) exclusion effective Dec 20, 2009.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
16359 Issued in LA
Legal business name
ZWOLLE MEDICAL CLINIC
Practice address
2114 Obrie Street
Zwolle, LA 71486-1068
Phone
(318) 645-4484
Fax
(318) 645-9139
NPI assigned
Apr 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Garland Dupree Miller Jr., MEDICAL DOCTORNPI 1144338088
Title
President
Phone
(318) 645-4484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 16359 LA Primary

Addresses

Primary practice location

2114 Obrie Street
Zwolle, LA 71486-1068

Mailing address

PO Box 1068
Zwolle, LA 71486-1068
Phone (318) 645-4484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory

Locations

2114 Obrie St
Zwolle, LA 71486
Phone (318) 645-4484

Practitioners & affiliated clinicians

Practitioners 2

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": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124149307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1068",
            "city": "ZWOLLE",
            "state": "LA",
            "postal_code": "714861068",
            "telephone_number": "318-645-4484",
            "fax_number": "318-645-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 OBRIE STREET",
            "city": "ZWOLLE",
            "state": "LA",
            "postal_code": "714861068",
            "telephone_number": "318-645-4484",
            "fax_number": "318-645-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZWOLLE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GARLAND",
        "authorized_official_middle_name": "DUPREE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-645-4484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MEDICAL DOCTOR"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "LA",
            "license": "16359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zwolle, LA

Sources for this page

Verify at the official NPI Registry.