NPIMap

Organization Active NPI

Winn Community Health Center, Inc.

Doing business as Lincoln Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
National Provider Identifier
1477090959
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
WINN COMMUNITY HEALTH CENTER, INC.
Doing business as
Lincoln Community Health Center
Practice address
1140 S Vienna St
Ruston, LA 71270-5834
Phone
(318) 224-7190
NPI assigned
Jan 23, 2017
Last updated
Jul 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Authorized official

Name
Deano Thornton
Title
Ceo
Phone
(318) 704-7190

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

1140 S Vienna St
Ruston, LA 71270-5834

Mailing address

PO Box 1288
Winnfield, LA 71483-1288
Phone (318) 648-0375

Other names 1

  • Lincoln 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
O20090918000491 LA Part B Supplier - Clinic/Group Practice 2567516545 Receives reassigned benefits from 101 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Marksville, LA; Winnfield, LA; Ruston, LA; Ringgold, LA; Pollock, LA; Dry Prong, LA; Colfax, LA; Bossier City, LA…
O20170320001595 LA Part A Provider - Federally Qualified Health Center (FQHC) 2567516545 Practice locations: Ruston, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477090959. Details of each certification follow.

Federally qualified health center certification: CCN 191975

Legal name
WINN COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 28, 2017
Last certification
Jul 28, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Nov 8, 2006 in LA
Enrollment address
1140 S Vienna St
Ruston, LA 71270-5834

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Deano Thornton Individual Corporate Director Mar 1, 2009
W-2 Managing Employee Mar 1, 2009
Glenda Melton Individual Corporate Director Jan 1, 2015
Betty Ashley Individual Corporate Director Jun 15, 2009
Brent Hubbard Individual Corporate Director Sep 1, 2012
Cynthia Jamison Individual Corporate Director Jan 1, 2015
Winn Community Health Center, Inc. Organization, Winnfield, LA Non-profit, Chain home office Operational/Managerial Control Apr 1, 2017
Charlie Jurek Individual Corporate Director Jun 15, 2009
June Melton Individual Corporate Director Jun 15, 2009
Brenda Jones Individual Corporate Director Jun 15, 2009
Joe Bass Individual Corporate Director Mar 1, 2009
Stanley King Individual Corporate Director Nov 1, 2009
Matthew Walton Individual Corporate Director Feb 16, 2016

All facility ownership & control disclosures 21

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grant Community Health CenterColfax, LA, CCN 191910 Federally qualified health center Operational/Managerial Control Feb 24, 2014
Bienville Community Health CenterRinggold, LA, CCN 191941 Federally qualified health center Operational/Managerial Control Sep 1, 2015
Winn Community Health Center, Inc.Pollock, LA, CCN 191979 Federally qualified health center Operational/Managerial Control Jul 17, 2017
Rapides Academy School Based ClinicAlexandria, LA, CCN 191080 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Cherokee Elementary School Based ClinicAlexandria, LA, CCN 191079 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Tioga Elementary School Based ClinicBall, LA, CCN 191078 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Hayden R Lawrence Upper EsbcDeville, LA, CCN 191085 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Oak Hill High School Based ClinicElmer, LA, CCN 191099 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Forest Hill Jr High School Based ClinicForest Hill, LA, CCN 191106 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Poland Jr. High School Based ClinicAlexandria, LA, CCN 191105 Federally qualified health center Operational/Managerial Control May 25, 2022
Plainview High School Based ClinicGlenmora, LA, CCN 191103 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Ball Elementary School Based ClinicBall, LA, CCN 191102 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Rapides High School Based ClinicLecompte, LA, CCN 191114 Federally qualified health center Operational/Managerial Control Mar 1, 2019
Carter C. Raymond Elementary School Based ClinicLecompte, LA, CCN 191113 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Alma Redwine EsbcAlexandria, LA, CCN 191164 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Paradise EsbcBall, LA, CCN 191171 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Ruby Wise Elementary SBCPineville, LA, CCN 191174 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Mary Goff Elementary SBCPineville, LA, CCN 191172 Federally qualified health center Operational/Managerial Control Mar 1, 2009
South Grant Community Health CenterDry Prong, LA, CCN 191186 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Winnfield Physical TherapyWinnfield, LA, CCN 191199 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Montgomery Community Health CenterMontgomery, LA, CCN 951198 Federally qualified health center Operational/Managerial Control Mar 1, 2009

Facilities with the same owner 21

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 21

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1485129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658275200000",
    "number": "1477090959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714831288",
            "telephone_number": "318-648-0375",
            "fax_number": "318-648-0378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 S VIENNA ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705834",
            "telephone_number": "318-224-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-23",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A",
        "authorized_official_last_name": "THORNTON",
        "authorized_official_first_name": "DEANO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "318-704-7190"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lincoln Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruston, LA

Sources for this page

Verify at the official NPI Registry.