NPIMap

Organization Active NPI

CLHG-Ville Platte LLC

Doing business as Fontenot Family Clinic

  • Family Medicine Physician
  • Ville Platte, LA
National Provider Identifier
1962128124
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CLHG-VILLE PLATTE LLC
Doing business as
Fontenot Family Clinic
Practice address
417 E Lincoln Rd Ste a
Ville Platte, LA 70586-3431
Phone
(337) 363-5684
NPI assigned
Oct 18, 2022
Last updated
Dec 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Kristopher Aguillard
Title
Ceo
Phone
(337) 363-9486

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

417 E Lincoln Rd Ste a
Ville Platte, LA 70586-3431

Mailing address

800 E Main St
Ville Platte, LA 70586-4618

Other names 1

  • Fontenot Family Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200401000467 LA Part B Supplier - Clinic/Group Practice 4486903309 Receives reassigned benefits from 93 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ville Platte, LA; Washington, LA

Other NPIs on the same Medicare enrollment 2

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
19D2315206Fontenot Family Clinic417 E Lincoln Rd, Ville Platte, LA 70586Certificate of waiverDec 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
CLHG-Ville Platte LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

417 E Lincoln Rd
#A
Ville Platte, LA 70586

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1962128124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E MAIN ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705864618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 E LINCOLN RD STE A",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705863431",
            "telephone_number": "337-363-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLHG-VILLE PLATTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "AGUILLARD",
        "authorized_official_first_name": "KRISTOPHER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-363-9486"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fontenot Family Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ville Platte, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.