Divinity Healthcare Clinic

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

DIVINITY HEALTHCARE CLINIC

Practice address

4021 We Heck CT Ste B1
Baton Rouge, LA 70816-0405

Phone

(225) 256-7945

Fax

(225) 351-8910

NPI assigned

Mar 31, 2020

Last updated

May 5, 2020By 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

Mrs. Dawn Melancon, FNPNPI 1548678469

Title

Family Nurse Practitioner

Phone

(225) 301-2982

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

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.

• Dawn Melancon, APRN, FNP-C

  • Family Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1548678469
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1326676792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11515 DENHAM RD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707377787",
            "telephone_number": "225-301-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 WE HECK CT STE B1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708160405",
            "telephone_number": "225-256-7945",
            "fax_number": "225-351-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINITY HEALTHCARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "MELANCON",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "225-301-2982",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diversity Health Services, LLC
• Divine Elevation, LLC
• Divine Expressions Speech and Hearing Services,LLC
• Divine Medical Transportation LLC
• Divine Touch Sitting Service LLC
• Natalie Dix
• Dixon Medical Clinic,Inc
• Dixon Transportation LC
• Barrett Andrew Dixon, FNP-C
• Deasia Dixon

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.