Organization Active NPI

DRW

Doing business as Bayou Family Care

  • Family Medicine Physician
  • Rayville, LA
National Provider Identifier
1497357156
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DRW
Doing business as
Bayou Family Care
Practice address
832 Julia St
Rayville, LA 71269-2608
Phone
(318) 728-4787
Fax
(318) 728-2598
NPI assigned
Nov 9, 2020
Last updated
Nov 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Authorized official

Name
Brittney Whitlock
Title
Credentialing Manager
Phone
(318) 325-6200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Family Nurse Practitioner 363LF0000X

Addresses

Primary practice location

832 Julia St
Rayville, LA 71269-2608

Mailing address

PO Box 15581
Monroe, LA 71207-5581

Other names 1

  • BAYOU FAMILY CARE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201203001185 LA Part B Supplier - Clinic/Group Practice 5092126672 Receives reassigned benefits from 3 practitioners
Practice locations: Rayville, LA

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
19D2199021Bayou Family Care832 Julia St, Rayville, LA 71269Certificate of waiverNov 4, 2026

National Provider Directory

National Provider Directory

Locations

832 Julia St
Rayville, LA 71269
Phone (318) 728-3831

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605484800000",
    "number": "1497357156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15581",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712075581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 JULIA ST",
            "city": "RAYVILLE",
            "state": "LA",
            "postal_code": "712692608",
            "telephone_number": "318-728-4787",
            "fax_number": "318-728-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRW",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "318-325-6200"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BAYOU FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BAYOU FAMILY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rayville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.