NPIMap

Organization Active NPI

Rayne Family Healthcare, LLC

  • Rural Health Clinic/Center
  • Rayne, LA
National Provider Identifier
1588147656
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
RAYNE FAMILY HEALTHCARE, LLC
Practice address
904 The Blvd Ste C
Rayne, LA 70578-6135
Phone
(337) 779-6000
NPI assigned
Sep 13, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Nicole Doucet, FNPNPI 1174520035
Title
Owner/Ceo
Phone
(337) 275-6915

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 1

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

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Rural health clinic certification: CCN 193966

Medicare enrollment files
Legal name
RAYNE FAMILY HEALTHCARE, LLC
Doing business as
RAYNE FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 28, 2020
Last certification
Mar 22, 2024
Ownership / control type
1B
Organization structure
LLCProprietary
Enrollment address
904 The Blvd
Ste C
Rayne, LA 70578-6135

All disclosed owners & managing parties 2

Medicare enrollment files

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

NameRoleSinceShare
Rayne Family Healthcare, LLC Organization, Rayne, LA LLC Operational/Managerial Control Aug 22, 2018 100%
Nicole H Doucet Individual 5% Or Greater Direct Ownership Interest Jan 16, 2019
Corporate OfficerCeo Aug 22, 2018 100%
W-2 Managing EmployeeCeo Aug 22, 2018 100%
Operational/Managerial ControlCeo Aug 22, 2018 100%

All facility ownership & control disclosures 1

Medicare enrollment files

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

FacilityTypeRoleSince
Rayne Family HealthcareRayne, LA, CCN 193966 Rural health clinic Operational/Managerial Control (100%) Aug 22, 2018

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20181031001087 LA Part a Provider - Rural Health Clinic 4789937293 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rayne, LA
O20181204002037 LA Part B Supplier - Clinic/Group Practice 4789937293 Receives reassigned benefits from 5 practitioners
Practice locations: Rayne, LA

National Provider Directory

National Provider Directory

Locations

119 S 5th St
Iota, LA 70543
Phone (337) 275-6915

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

904 The Blvd Ste C
Rayne, LA 70578-6135

Mailing address

119 S 5TH St
Iota, LA 70543-6105
Phone (337) 779-6000

Other names 1

NPPES NPI Registry
  • Rayne Family Healthcare Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 16, 2023.

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1588147656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S 5TH ST",
            "city": "IOTA",
            "state": "LA",
            "postal_code": "705436105",
            "telephone_number": "337-779-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 THE BLVD STE C",
            "city": "RAYNE",
            "state": "LA",
            "postal_code": "705786135",
            "telephone_number": "337-779-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYNE FAMILY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-13",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "DOUCET",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "337-275-6915",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rayne Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rayne Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rayne, LA

Sources for this page

Verify at the official NPI Registry.