Louisiana Family Medicine Clinic

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

LOUISIANA FAMILY MEDICINE CLINIC

Practice address

2890 Douglas Dr
Ste. 100
Bossier City, LA 71111-5806

Phone

(318) 742-6900

Fax

(318) 742-3900

NPI assigned

Jun 4, 2015

Organization subpart

No

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

Authorized official

Name

Dirk T. Rainwater, MDNPI 1043286230

Title

Owner

Phone

(318) 259-1569

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

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.

• Louisiana Family Medicine Clinic, Inc.

  • Non-Pharmacy Dispensing Site
  • Jonesboro, LA
  • NPI 1083094007
  NPD tax ID

Practitioners 1

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

• Dirk Timothy Rainwater, MD

  • General Practice Physician
  • Jonesboro, LA
  • NPI 1043286230
  NPD (past) Authorized official

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": "1174903249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 DOUGLAS DR",
            "address_2": "STE. 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115806",
            "telephone_number": "318-742-6900",
            "fax_number": "318-742-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 DOUGLAS DR",
            "address_2": "STE. 100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711115806",
            "telephone_number": "318-742-6900",
            "fax_number": "318-742-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA FAMILY MEDICINE CLINIC",
        "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_middle_name": "T.",
        "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": []
}

• Louise S Davis Residential Facilities, LLC
• Louisiana CVS Pharmacy LLC
• Louisiana CVS Pharmacy LLC
• Louisiana CVS Pharmacy, L.L.C.
• Louisiana CVS Pharmacy, L.L.C.
• Louisiana Physical Therapy Services of Bossier City, LLC
• Ursula Luckett
• Mary Luckey, PT
• Hanh Hong Luong
• Nancy Dinh Ly, DDS

• Non-Pharmacy Dispensing Site in Bossier City, LA
• Providers in Bossier City, LA by specialty
• Non-Pharmacy Dispensing Site in Louisiana

• 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.
• 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.