Advantage Health Urgent Care LLC

Key facts

NPI: 1194435107
Entity type: Organization (NPI type 2)
Primary specialty: Acute Care Nurse Practitioner 363LA2100X
Legal business name: ADVANTAGE HEALTH URGENT CARE LLC
Practice address: 906 N Pine St
Deridder, LA 70634-2816
Phone: (337) 396-3833
NPI assigned: Nov 30, 2022
Organization subpart: No

Authorized official

Name: Mrs. Heather Marie Daniels, DNP, APRN, FNP-C
Title: Nurse Practitioner/Business Owner
Phone: (337) 396-3833

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Advantage Health Primary Care LLC Family Nurse Practitioner · Deridder, LA · NPI 1427876911

NPPES parent name

Practitioners 3

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

Jennifer Lee Cooley, FNP Family Nurse Practitioner · Deridder, LA · NPI 1982185799

Medicare reassignment Care Compare group NPD LA · MULTI-SPECIALTY
Heather Daniels, DNP, APRN, FNP-C Nurse Practitioner · Leesville, LA · NPI 1598280810

Medicare reassignment Care Compare group NPD LA
Tracy Jacobs, FNP Nurse Practitioner · Leesville, LA · NPI 1750877825

Medicare reassignment Care Compare group NPD LA

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
19D2296336	Advantage Health Urgent Care 906 North Pine Street, Deridder, LA 70634	Certificate of waiver	Dec 26, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in LA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20221230000666	LA	Part B Supplier - Clinic/Group Practice	6608246053	Receives reassigned benefits from 3 practitioners Practice locations: Deridder, LA

National Provider Directory

Locations

2900 Gerstner Memorial Dr
Lake Charles, LA 70601
Phone (337) 485-4185

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Acute Care Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LA2100X			Yes

Addresses

Primary practice location

906 N Pine St
Deridder, LA 70634-2816

Mailing address

906 N Pine St
Deridder, LA 70634-2816

Other providers in Deridder, LA

A2H-BLM LLC
Ab Craig Aprn LLC
Accesscare Advance Practice
Michelle W Adams, FNP-C
Advantage Health Primary Care LLC
Hamid Alipour, MD
Allegiance Home Health of Southwest Louisiana, LLC
Alexis J Amato, LAT, ATC
James Christian Armetta, SLP.D.
Ashley McCoy

All providers in Deridder, LA · Acute Care Nurse Practitioner in Louisiana

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.