NPIMap

Organization Active NPI

Iberia Comprehensive Community Health Center,Inc.

  • Federally Qualified Health Center (FQHC)
  • New Iberia, LA
National Provider Identifier
1922046549
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER,INC.
Practice address
806 Jefferson Ter
New Iberia, LA 70562-5727
Phone
(337) 365-4945
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Authorized official

Name
Mr. De'Marquis Hamilton
Title
Ceo
Phone
(337) 365-4945

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

806 Jefferson Ter
New Iberia, LA 70562-5727

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other identifiers 1

IdentifierTypeStateIssuer
1940984MedicaidLA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050809000029 LA Part B Supplier - Clinic/Group Practice 6204817828 Receives reassigned benefits from 43 practitioners
9 other NPIs on this enrollment
Practice locations: Leesville, LA; Saint Martinville, LA; New Iberia, LA; Merryville, LA; Many, LA; Lafayette, LA; Deridder, LA; Abbeville, LA
O20080404000756 LA Part A Provider - Federally Qualified Health Center (FQHC) 6204817828 Practice locations: New Iberia, LA

Federally qualified health center certification: CCN 191811

Legal name
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER,INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
Apr 29, 1985 in LA
Enrollment address
806 Jefferson Ter
New Iberia, LA 70560-5727

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 9

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

Other NPIs on the same Medicare enrollment 9

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

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
19D0883662Iberia Comprehensive Community Health806 Jefferson Terrace, New Iberia, LA 70560Certificate of waiverOct 9, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Jones Individual Corporate DirectorBoard Member Nov 26, 2019 0.06%
Joann Nixon Individual Corporate DirectorTreasurer - Board Member Oct 26, 2004 0.06%
Paula Smith Individual Corporate DirectorBoard Member Feb 28, 2012 0.06%
Sharon Ann Williams Individual Corporate DirectorBoard Member Jul 1, 2000 0.06%
Bradley Fulgence Individual Corporate DirectorPresident - Board Member Mar 31, 2009 0.06%
Sandra Moore Individual Corporate DirectorBoard Member Jan 14, 1999 0.06%
Nathaniel Mitchell Individual Corporate DirectorVice-President Board Member Jun 27, 2017 0.06%
Megan Reed Individual Corporate OfficerBilling Manager Apr 1, 2024 100%
W-2 Managing EmployeeBilling Manager Apr 1, 2025 100%
Margaret Green Individual Corporate DirectorBoard Member Mar 31, 2009 0.06%
Phanat Xanamane Individual Corporate DirectorBoard Member Jul 28, 2015 0.06%

Subparts reporting this organization as parent 15

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

View all 15

Practitioners & affiliated clinicians

Practitioners 54

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

View all 54

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1922046549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705625727",
            "telephone_number": "337-365-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "DE'MARQUIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-365-4945",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1940984",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.