NPIMap

Organization Active NPI

Rayne Family Healthcare, LLC

Doing business as Rayne Family Healthcare

  • 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
Doing business as
Rayne Family Healthcare
Practice address
904 The Blvd Ste C
Rayne, LA 70578-6135
Phone
(337) 779-6000
NPI assigned
Sep 13, 2018
Last updated
Oct 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

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.

Specialties & licenses 1

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

Addresses

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

  • Rayne Family Healthcare Doing business as

Medicare participation

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

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1588147656. Details of each certification follow.

Rural health clinic certification: CCN 193966

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

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

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

911 The Blvd
Rayne, LA 70578
Phone (337) 393-2052

Ownership & related parties

All disclosed owners & managing parties 2

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%

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 6

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": "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.