Organization Active NPI

Barousse Family Clinic LLC

  • Rural Health Clinic/Center
  • Church Point, LA
National Provider Identifier
1811657752
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BAROUSSE FAMILY CLINIC LLC
Practice address
408 W Canal St
Church Point, LA 70525-3402
Phone
(337) 684-8001
Fax
(337) 684-8003
NPI assigned
Dec 20, 2021
Last updated
Apr 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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

Authorized official

Name
Megan Barousse, NPNPI 1033550686
Title
Owner
Phone
(337) 684-8001

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

408 W Canal St
Church Point, LA 70525-3402

Mailing address

408 W Canal St
Church Point, LA 70525-3402
Phone (337) 684-8001

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220112001882 LA Part B Supplier - Clinic/Group Practice 2365834835 Receives reassigned benefits from 4 practitioners
Practice locations: Church Point, LA
O20230221003376 LA Part A Provider - Rural Health Clinic 2365834835 Practice locations: Church Point, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811657752. Details of each certification follow.

Rural health clinic certification: CCN 198910

Legal name
BAROUSSE FAMILY CLINIC LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 30, 2022
Last certification
Dec 30, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Dec 8, 2021 in LA
Enrollment address
408 W Canal St
Church Point, LA 70525-3402

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2250077Barousse Family Clinic LLC408 West Canal Street, Church Point, LA 70525Certificate of waiverJan 24, 2028

National Provider Directory

National Provider Directory

Locations

408 W Canal St
Church Point, LA 70525
Phone (337) 684-8001

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
Nicole Simon Individual W-2 Managing EmployeeOffice Manager Jun 1, 2022
Megan Deshotel Barousse Individual 5% Or Greater Direct Ownership Interest Dec 8, 2021 100%
W-2 Managing Employee Jun 1, 2022

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 4

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": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1811657752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W CANAL ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705253402",
            "telephone_number": "337-684-8001",
            "fax_number": "337-684-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W CANAL ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705253402",
            "telephone_number": "337-684-8001",
            "fax_number": "337-684-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAROUSSE FAMILY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "BAROUSSE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-684-8001",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Church Point, LA

Sources for this page

Verify at the official NPI Registry.