Winn Community Health Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Ruston, LA
NPI 1477090959 · NPPES record last updated Jul 20, 2022
Key facts
- NPI
- 1477090959
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- WINN COMMUNITY HEALTH CENTER, INC.
- Practice address
- 1140 S Vienna St
Ruston, LA 71270-5834 - Phone
- (318) 224-7190
- NPI assigned
- Jan 23, 2017
- Organization subpart
- No
Authorized official
- Name
- Deano Thornton
- Title
- Ceo
- Phone
- (318) 704-7190
Other NPIs on the same Medicare enrollment 8
Facilities with the same owner 21
Practitioners 16
-
Morgan L Batten, NP
-
Melani Craig, FNP-C
-
Julie Evans, LPC
-
Amanda Lea Faith, APRN
-
Lisa Robinson Lauve, FNP
-
Tiffany Slaughter, FNP-C
-
James J. Morris, PH.D.
-
Randall Silven Johnston II, A-GNP-C
-
Tamara Dianne McAdams, NP-C
-
Mallorie McDowell Parham, PA-C
-
Megan Rainwater Scott, APRN-CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
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
- Corporation · Non-profit
- Incorporated
- Nov 8, 2006 in LA
- Enrollment address
- 1140 S Vienna St
Ruston, LA 71270-5834
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Deano Thornton |
Corporate Director | Mar 1, 2009 | |
| W-2 Managing Employee | Mar 1, 2009 | ||
| Glenda Melton |
Corporate Director | Jan 1, 2015 | |
| Betty Ashley |
Corporate Director | Jun 15, 2009 | |
| Brent Hubbard |
Corporate Director | Sep 1, 2012 | |
| Cynthia Jamison |
Corporate Director | Jan 1, 2015 | |
| Winn Community Health Center, Inc. |
Operational/Managerial Control | Apr 1, 2017 | |
| Charlie Jurek |
Corporate Director | Jun 15, 2009 | |
| June Melton |
Corporate Director | Jun 15, 2009 | |
| Brenda Jones |
Corporate Director | Jun 15, 2009 | |
| Joe Bass |
Corporate Director | Mar 1, 2009 | |
| Stanley King |
Corporate Director | Nov 1, 2009 | |
| Matthew Walton |
Corporate Director | Feb 16, 2016 |
All facility ownership & control disclosures 21
| Facility | Type | Role | Since |
|---|---|---|---|
| Grant Community Health Center |
Federally qualified health center | Operational/Managerial Control | Feb 24, 2014 |
| Bienville Community Health Center |
Federally qualified health center | Operational/Managerial Control | Sep 1, 2015 |
| Winn Community Health Center, Inc. |
Federally qualified health center | Operational/Managerial Control | Jul 17, 2017 |
| Rapides Academy School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Cherokee Elementary School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Tioga Elementary School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Hayden R Lawrence Upper Esbc |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Oak Hill High School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Forest Hill Jr High School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Poland Jr. High School Based Clinic |
Federally qualified health center | Operational/Managerial Control | May 25, 2022 |
| Plainview High School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Ball Elementary School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Rapides High School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2019 |
| Carter C. Raymond Elementary School Based Clinic |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Alma Redwine Esbc |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Paradise Esbc |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Ruby Wise Elementary SBC |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Mary Goff Elementary SBC |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| South Grant Community Health Center |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Winnfield Physical Therapy |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
| Montgomery Community Health Center |
Federally qualified health center | Operational/Managerial Control | Mar 1, 2009 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
Locations
800 Ola St
Alexandria, LA 71303
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | |||
| General Practice Dentistry |
1223G0001X | |||
| Family Medicine Physician |
207Q00000X | |||
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes | ||
| Nurse Practitioner |
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
- Lincoln Community Health Center
Other providers in Ruston, LA
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Winn Community Health Center, Inc.
- Rebekah Wisterman
- Gabriel Milan Witherington
- Paige H Witt
All providers in Ruston, LA · Federally Qualified Health Center (FQHC) in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2022. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.