NPIMap

Organization Active NPI

Winn Community Health Center, Inc.

Doing business as Pineville High School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Pineville, LA
National Provider Identifier
1497377337
Registry record updated May 14, 2020
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
Pineville High School Based Clinic
Practice address
1511 Line St
Pineville, LA 71360-5033
Phone
(318) 648-0375
NPI assigned
May 14, 2020
Last updated
May 14, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
WINN COMMUNITY HEALTH CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Authorized official

Name
David Adams
Title
Coo
Phone
(318) 648-0375

Specialties & licenses 1

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

Addresses

Primary practice location

1511 Line St
Pineville, LA 71360-5033

Mailing address

PO Box 1288
Winnfield, LA 71483-1288
Phone (318) 209-4910

Other names 1

  • Pineville High School Based Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200720000835 LA Part A Provider - Federally Qualified Health Center (FQHC) 2567516545 Practice locations: Pineville, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497377337. Details of each certification follow.

Federally qualified health center certification: CCN 191040

Legal name
WINN COMMUNITY HEALTH CENTER, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 17, 2020
Last certification
Jul 17, 2020
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 2020 in LA
Enrollment address
1511 Line St
Pineville, LA 71360-5033

National Provider Directory

National Provider Directory
Tax ID family
Winn Community Health Center65 organizations share this tax ID, including this one
Part of
Winn Community Health Center

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2727 Jones Ave
Alexandria, LA 71302
Phone (318) 209-4510

Ownership & related parties

All disclosed owners & managing parties 11

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 5% Or Greater Direct Ownership Interest Jun 15, 2009
W-2 Managing Employee Jun 15, 2009
Glenda Melton Individual Corporate Director Jan 1, 2015
Betty Ashley Individual Corporate Director Mar 1, 2009
Brent Hubbard Individual Corporate Director Sep 1, 2012
Cynthia Jamison Individual Corporate Director Jan 1, 2015
Charlie Jurek Individual Corporate Director Jun 15, 2009
June Melton Individual Corporate Director Jul 1, 2009
Brenda Jones Individual Corporate Director Feb 1, 2013
Joe Bass Individual Corporate Director Jun 15, 2009
Stanley King Individual Corporate Director Jul 1, 2009
Matthew Walton Individual Corporate Director Feb 1, 2016

All facility ownership & control disclosures 22

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.Ruston, LA, CCN 191975 Federally qualified health center Operational/Managerial Control Apr 1, 2017
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

Practitioners & affiliated clinicians

Practitioners 10

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": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1497377337",
    "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": "318-209-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 LINE ST",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713605033",
            "telephone_number": "318-648-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-648-0375"
    },
    "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": "Pineville High School Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pineville, LA

Sources for this page

Verify at the official NPI Registry.