NPIMap

Organization Active NPI

Winn Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winnfield, LA
National Provider Identifier
1689154387
Registry record updated Jun 26, 2019
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.
Practice address
631 Thomas Mill Rd
Winnfield, LA 71483-6063
Phone
(318) 302-3263
NPI assigned
Aug 21, 2018
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 8

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Federally qualified health center certification: CCN 191063

Legal name
WINN COMMUNITY HEALTH CENTER, INC.
Doing business as
WINNFIELD SENIOR HIGH SBC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 10, 2021
Last certification
May 10, 2021
Ownership / control type
For profit – corporation
Organization structure
Corporation · Non-profit
Enrollment address
631 Thomas Mill Rd
Winnfield, LA 71483-6063

All disclosed owners & managing parties 12

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
Kaye Pyles
Individual 		Corporate Director Aug 20, 2020
Katina Smith
Individual 		Corporate Director Aug 20, 2020
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 Jun 15, 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 Center
Colfax, LA · CCN 191910		 Federally qualified health center Operational/Managerial Control Feb 24, 2014
Bienville Community Health Center
Ringgold, 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 Clinic
Alexandria, LA · CCN 191080		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Cherokee Elementary School Based Clinic
Alexandria, LA · CCN 191079		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Tioga Elementary School Based Clinic
Ball, LA · CCN 191078		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Hayden R Lawrence Upper Esbc
Deville, LA · CCN 191085		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Oak Hill High School Based Clinic
Elmer, LA · CCN 191099		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Forest Hill Jr High School Based Clinic
Forest Hill, LA · CCN 191106		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Poland Jr. High School Based Clinic
Alexandria, LA · CCN 191105		 Federally qualified health center Operational/Managerial Control May 25, 2022
Plainview High School Based Clinic
Glenmora, LA · CCN 191103		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Ball Elementary School Based Clinic
Ball, LA · CCN 191102		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Rapides High School Based Clinic
Lecompte, LA · CCN 191114		 Federally qualified health center Operational/Managerial Control Mar 1, 2019
Carter C. Raymond Elementary School Based Clinic
Lecompte, LA · CCN 191113		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Alma Redwine Esbc
Alexandria, LA · CCN 191164		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Paradise Esbc
Ball, LA · CCN 191171		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Ruby Wise Elementary SBC
Pineville, LA · CCN 191174		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Mary Goff Elementary SBC
Pineville, LA · CCN 191172		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
South Grant Community Health Center
Dry Prong, LA · CCN 191186		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Winnfield Physical Therapy
Winnfield, LA · CCN 191199		 Federally qualified health center Operational/Managerial Control Mar 1, 2009
Montgomery Community Health Center
Montgomery, LA · CCN 951198		 Federally qualified health center Operational/Managerial Control Mar 1, 2009

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210511000987 LA Part a Provider - Federally Qualified Health Center (FQHC) 2567516545 Practice locations: Winnfield, LA

National Provider Directory

Tax ID family
Winn Comm HLTH Ctr Inc (65 organizations share this tax ID)

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

NPPES NPI Registry

Primary practice location

631 Thomas Mill Rd
Winnfield, LA 71483-6063

Mailing address

PO Box 1288
Winnfield, LA 71483-1288
Phone (318) 648-0375

Other names 1

NPPES NPI Registry
  • Winnfield Senior High School-Based Clinic 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 Jun 26, 2019.

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1689154387",
    "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": "318-648-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 THOMAS MILL RD",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714836063",
            "telephone_number": "318-302-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2019-06-26",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Winnfield Senior High School-Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Winnfield Senior High School-Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winnfield, LA

Sources for this page

Verify at the official NPI Registry.