Innis Community Health Center, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Rosedale, LA
NPI 1962285262 · NPPES record last updated Aug 20, 2026
Key facts
- NPI
- 1962285262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- INNIS COMMUNITY HEALTH CENTER, INC
- Practice address
- 13770 Highway 77
Rosedale, LA 70772 - Phone
- (225) 687-5400
- Fax
- (225) 442-3107
- NPI assigned
- Aug 18, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- INNIS COMMUNITY HEALTH CENTER, INC
Authorized official
- Name
- Cindy Griffin Peavy
- Title
- Executive Director
- Phone
- (225) 618-7161
Parent organization (reported in NPPES) 1
Other NPIs on the same Medicare enrollment 6
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 12
Practitioners 17
-
Lawrence C Carter, M.D.
-
Bria Henderson, NP
-
Michael Paul Ramagos, M.D.
-
Alvin Jacob Laprarie, APRN, FNP-C
-
Jeremy Brandon Courville, FNP-C
-
Katelyn A Dupre, PMHNP
-
Angela Marie Finley, PA-C
-
Tonette Harris-Haynes, PMHNP
-
Melinda A Levi, FNP-BC
-
Kathleen Marie Shaw, LPC
-
James J. Morris, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
Federally qualified health center certification: CCN 191180
- Legal name
- INNIS COMMUNITY HEALTH CENTER, INC
- Doing business as
- NORTH IBERVILLE SCHOOL BASED HEALTH CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Mar 8, 2024
- Last certification
- Mar 8, 2024
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 13770 Highway 77
Rosedale, LA 70772
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Marilu Corona |
Corporate Director |
Jan 1, 2024 | |
| Dania Tolliver |
Corporate Director |
Jan 1, 2024 | |
| Jennifer Lacour |
Corporate Director |
Jan 1, 2024 | |
| Beulah Epps |
Corporate Director |
Jan 1, 2024 | |
| Irma Smith |
Corporate Director |
Jan 1, 2024 | |
| Gary Scronce |
Corporate Director |
Jan 1, 2024 | |
| Cindy G Peavy |
Corporate Director |
Jan 1, 2024 | |
| W-2 Managing Employee |
Jan 1, 2024 | ||
| Frances Sagona |
Corporate Director |
Jan 1, 2024 | |
| Rachel Nelson |
W-2 Managing Employee |
Jan 1, 2024 | |
| Chad Olinde |
Corporate Director |
Jan 1, 2024 | |
| Mary Wells |
Corporate Director |
Jan 1, 2024 | |
| Jordan Frey |
Corporate Director |
Jan 1, 2024 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050825000691 | LA | Part B Supplier - Clinic/Group Practice | 9931130358 |
Receives reassigned benefits from 27 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: New Roads, LA; Maringouin, LA; Livonia, LA; Batchelor, LA |
| O20240308002016 | LA | Part a Provider - Federally Qualified Health Center (FQHC) | 9931130358 | Practice locations: Rosedale, LA |
National Provider Directory
- Tax ID family
- Innis Community Health Center Inc
- Part of
- Innis Community Health Center Inc
Locations
6450 LA Highway 1
Batchelor, LA 70715
Phone (225) 618-5015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
13770 Highway 77
Rosedale, LA 70772
Mailing address
6450 La Highway 1
Batchelor, LA 70715-3212
Phone (225) 618-5015
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2652362 | Medicaid | LA |
Other names
- North Iberville School Based Health Center
- Arbor Family Health
- Innis Community Health Center, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.