NRMC Walk-in Clinic Ventures, LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

NRMC WALK-IN CLINIC VENTURES, LLC

Practice address

740 Keyser Ave
Suite E
Natchitoches, LA 71457-6037

Phone

(318) 238-5300

Fax

(318) 238-5301

NPI assigned

Apr 24, 2015

Organization subpart

No

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

Authorized official

Name

Mr. William Bradford McCormick

Title

Cfo

Phone

(318) 214-4350

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Natchitoches Parish Hospital Service District

  • Psychiatric Hospital Unit
  • Natchitoches, LA
  • NPI 1467522144

  Member Of

  NPD member

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Natchitoches Parish Hospital Service District

  • Rural Health Clinic/Center
  • Natchitoches, LA
  • NPI 1902490394

  Sold to, 2021-02-26

  CMS change of ownership

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

{
    "created_epoch": "1429833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593129600000",
    "number": "1306233572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2475",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714572475",
            "telephone_number": "318-238-5300",
            "fax_number": "318-238-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 KEYSER AVE",
            "address_2": "SUITE E",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576037",
            "telephone_number": "318-238-5300",
            "fax_number": "318-238-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NRMC WALK-IN CLINIC VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-24",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BRADFORD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-214-4350",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "000000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2418297",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2489445",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NRMC Physician Ipa Inc
• NRMC Physician Ipa Inc
• NRMC Physician Ipa Inc
• Fallon Dai O'Bannon, RSW
• Oladele Oladiran
• Moshood Olatinwo, MD
• Blanca Ivelisse Osorio, M.D
• Christopher Oswald

• All providers in Natchitoches, LA
• Rural Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.