Med One Health Clinic, LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

MED ONE HEALTH CLINIC, LLC

Practice address

349 Dogwood South LN
Haughton, LA 71037-8511

Phone

(832) 870-8375

NPI assigned

Feb 10, 2025

Last updated

Feb 12, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Latrisala Bankston, NPNPI 1972097491

Title

Owner

Phone

(832) 870-8375

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA, TX, FL, TN4 enrollments

Enrollment records 4

Locations

Practitioners 2

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.

• Latrisala Bankston, NP

  • Family Nurse Practitioner
  • Tomball, TX
  • NPI 1972097491

  FL, LA, TN

  Medicare reassignment NPD Authorized official
• Sevara Jean Bailey, NP

  • Family Nurse Practitioner
  • Plantation, FL
  • NPI 1770028409
  NPD

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1609681345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "349 DOGWOOD SOUTH LN",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 DOGWOOD SOUTH LN",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710378511",
            "telephone_number": "832-870-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MED ONE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "BANKSTON",
        "authorized_official_first_name": "LATRISALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-870-8375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Michael McCormick, D.D.S.
• Ashlei McDonald
• Phillip Anthony McKee Jr., P.T.
• Lundell Lee McKittrick, D.C.
• Aaron Royce McManus, PLPC
• Tonia Miller
• Mind Over Matter Behavioral Health Center
• Minden Physician Practices LLC (Minden Medical Clinic of Haughton)
• Cindy Lane Moore, RPH
• Kirstin Usie Mosley

• Primary Care Nurse Practitioner in Haughton, LA
• Providers in Haughton, LA by specialty
• Primary Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.