NPIMap

Organization Active NPI

Innis Community Health Center, Inc

Doing business as North Iberville School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Rosedale, LA
National Provider Identifier
1962285262
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
INNIS COMMUNITY HEALTH CENTER, INC
Doing business as
North Iberville School Based Health Center
Practice address
13770 Highway 77
Rosedale, LA 70772
Phone
(225) 385-2668
Fax
(225) 442-3107
NPI assigned
Aug 18, 2023
Last updated
Oct 7, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
INNIS COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Authorized official

Name
Cindy Griffin Peavy
Title
Executive Director
Phone
(225) 618-7161

Specialties & licenses 1

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

Addresses

Primary practice location

13770 Highway 77
Rosedale, LA 70772

Mailing address

112 Telly St
New Roads, LA 70760-2521
Phone (225) 618-5015

Other names 2

  • North Iberville School Based Health Center Doing business as
  • Arbor Family Health Other name

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962285262. Details of each certification follow.

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
CorporationNon-profit
Enrollment address
13770 Highway 77
Rosedale, LA 70772

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Livonia Comm Health Ctr14 organizations share this tax ID, including this one
Part of
Livonia Comm Health Ctr

Other organizations with this tax ID 13

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

View all 13

Locations

13770 Highway 77
Maringouin, LA 70757
Phone (225) 287-5400

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Marilu Corona Individual Corporate DirectorBoard Member Jan 1, 2024
Dania Tolliver Individual Corporate DirectorBoard Member Jan 1, 2024
Jennifer Lacour Individual Corporate DirectorBoard Member Jan 1, 2024
Beulah Epps Individual Corporate DirectorBoard Member Jan 1, 2024
Irma Smith Individual Corporate DirectorBoard Member Jan 1, 2024
Gary Scronce Individual Corporate DirectorBoard Member Jan 1, 2024
Cindy G Peavy Individual Corporate DirectorExecutive Director Jan 1, 2024
W-2 Managing EmployeeExecutive Director Jan 1, 2024
Frances Sagona Individual Corporate DirectorBoard Member Jan 1, 2024
Rachel Nelson Individual W-2 Managing EmployeeChief Administrative Officer Jan 1, 2024
Chad Olinde Individual Corporate DirectorBoard Member Jan 1, 2024
Mary Wells Individual Corporate DirectorBoard Member Jan 1, 2024
Jordan Frey Individual Corporate DirectorBoard Member Jan 1, 2024

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791331200000",
    "number": "1962285262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TELLY ST",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602521",
            "telephone_number": "225-618-5015",
            "fax_number": "225-442-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13770 HIGHWAY 77",
            "city": "ROSEDALE",
            "state": "LA",
            "postal_code": "70772",
            "telephone_number": "225-385-2668",
            "fax_number": "225-442-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INNIS COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2023-08-18",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "PEAVY",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "GRIFFIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "225-618-7161"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Iberville School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Iberville School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arbor Family Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Sources for this page

Verify at the official NPI Registry.