Family Wellness Practice LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

FAMILY WELLNESS PRACTICE LLC

Practice address

411 S Pine St
Deridder, LA 70634-4839

Phone

(337) 462-6070

NPI assigned

Feb 28, 2022

Last updated

Aug 31, 2022By 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

Brenda Mahaffey, APRN, FNP-CNPI 1629738190

Title

Owner

Phone

(337) 221-2990

Specialties & licenses 2

Addresses

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.

• Brenda Renee Mahaffey, APRN

  • Primary Care Nurse Practitioner
  • Deridder, LA
  • NPI 1629738190
  Authorized official Same address or phone
• Jeffrey Dobbins, M.D.

  • Family Medicine Physician
  • Deridder, LA
  • NPI 1275845091
  NPD

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661904000000",
    "number": "1720734841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344839",
            "telephone_number": "337-221-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S PINE ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344839",
            "telephone_number": "337-462-6070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY WELLNESS PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A",
        "authorized_official_last_name": "MAHAFFEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-221-2990",
        "authorized_official_credential": "APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dva Renal Healthcare Inc (DeRidder Dialysis)
• Nichole Millette Edwards
• Jeremy Erwin, MA, LPC
• Family Health Partners
• Family Healthcare of Beauregard, L.L.C. (Edwin R. Bonilla, M.D.)
• Steven C Farquhar, MD
• Jillian Daisy Farrow
• Tate Fazio, CRNA
• Sheila Feldtman
• Tera Ann Fisher

• Primary Care Nurse Practitioner in Deridder, LA
• Providers in Deridder, 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 Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.