Community Healthcare Clinic, LLC

Key facts

NPI: 1396138145
Entity type: Organization (NPI type 2)
Primary specialty: Adult Health Nurse Practitioner 363LA2200X
License: AP04925 (LA)
Legal business name: COMMUNITY HEALTHCARE CLINIC, LLC
Practice address: 1421 Henderson Highway
Henderson, LA 70517
Phone: (337) 434-6146
Fax: (337) 464-6149
NPI assigned: Mar 17, 2015
Organization subpart: No

Authorized official

Name: Ms. Aimee D, Guidry, ANP-C
Title: Owner
Phone: (337) 288-1508

Practitioners 1

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

Aimee Guidry, NP Nurse Practitioner · Henderson, LA · NPI 1679673412

Medicare reassignment 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
19D2008615	Community Healthcare Clinic, LLC 1421 Henderson Hwy, Henderson, LA 70517	Certificate of waiver	Jun 14, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in LA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20150430000197	LA	Part B Supplier - Clinic/Group Practice	8628397486	Receives reassigned benefits from 1 practitioner Practice locations: Henderson, LA

National Provider Directory

Locations

1421 Henderson Hwy
Henderson, LA 70517
Phone (337) 434-6082

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Health Nurse Practitioner Group: 193400000X SINGLE SPECIALTY GROUP	363LA2200X	AP04925	LA	Yes

Addresses

Primary practice location

1421 Henderson Highway
Henderson, LA 70517

Mailing address

PO Box 597
Henderson, LA 70517-0597
Phone (337) 434-6146

Other identifiers

Identifier	Type	State	Issuer
1820466	Medicaid	LA

Other providers in Henderson, LA

All providers in Henderson, LA · Adult Health 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 Mar 17, 2015. 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.