NPIMap

Organization Active NPI

Iberia Comprehensive Community Health Center, Inc.

Doing business as DeRidder Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Deridder, LA
National Provider Identifier
1457235368
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC.
Doing business as
DeRidder Community Health Center
Practice address
427 N Pine St Ste a
Deridder, LA 70634-3905
Phone
(337) 365-4945
NPI assigned
Aug 4, 2025
Last updated
Aug 4, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Megan Reed
Title
Billing Manager
Phone
(337) 365-4945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

427 N Pine St Ste a
Deridder, LA 70634-3905

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other names 1

  • DeRidder Community Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050809000029 LA Part B Supplier - Clinic/Group Practice 6204817828 Receives reassigned benefits from 43 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leesville, LA; Saint Martinville, LA; New Iberia, LA; Merryville, LA; Many, LA; Lafayette, LA; Deridder, LA; Abbeville, LA
O20251121001504 LA Part A Provider - Federally Qualified Health Center (FQHC) 6204817828 Practice locations: Deridder, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1457235368. Details of each certification follow.

Federally qualified health center certification: CCN 951005

Legal name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER,INC.
Doing business as
DERIDDER COMMUNITY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2025
Last certification
Oct 16, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
427 N Pine St
Ste a
Deridder, LA 70634-3905

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2330708Deridder Community Health Center427 North Pine St Suite a, Deridder, LA 70634Certificate of waiverSep 21, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Martin Parish CHC Pharmacy15 organizations share this tax ID, including this one
Part of
St Martin Parish CHC Pharmacy

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

427 N Pine St
#A
Deridder, LA 70634
Phone (337) 365-4945

317 Dernier St
Saint Martinville, LA 70582
Phone (337) 342-2566

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Joann Nixon Individual Corporate DirectorBoard Member Oct 26, 2004
Bradley Fulgence Individual Corporate DirectorBoard Member Mar 31, 2009
Megan Reed Individual Corporate OfficerBilling Manager Apr 1, 2024 100%
W-2 Managing EmployeeBilling Manager Apr 1, 2024 100%
Margaret Green Individual Corporate DirectorBoard Member Mar 31, 2009

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 43

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.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1457235368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N PINE ST STE A",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706343905",
            "telephone_number": "337-365-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "337-365-4945"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeRidder Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.