Winn Community Health Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

WINN COMMUNITY HEALTH CENTER, INC.

Doing business as

Bolton High School Based Clinic

Practice address

2101 Vance Ave
Alexandria, LA 71301-6059

Phone

(318) 648-0375

NPI assigned

May 14, 2020

Last updated

May 14, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

WINN COMMUNITY HEALTH CENTER, INC.As reported in NPPES

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

Authorized official

Name

David Adams

Title

Coo

Phone

(318) 648-0375

Specialties & licenses 1

Addresses

Other names 1

• Bolton High School Based Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972125813. Details of each certification follow.

• CCN 191036 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 191036

Legal name

WINN COMMUNITY HEALTH CENTER, INC.

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 16, 2020

Last certification

Jul 16, 2020

Ownership / control type

For profit – corporation

Organization structure

CorporationNon-profit

Incorporated

Jul 1, 2020 in LA

Enrollment address

2101 Vance Ave
Alexandria, LA 71301-6059

Tax ID family

Winn Comm HLTH Ctr Inc65 organizations share this tax ID, including this one

Part of

Winn Comm HLTH Ctr Inc

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Winn Community Health Center, Inc.

  dba Arthur F. Smith Middle Magnet School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1790307635
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Carter C. Raymond Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Lecompte, LA
  • NPI 1801530621
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Bossier Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Bossier City, LA
  • NPI 1801600143
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Hayden R. Lawrence Upper Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Deville, LA
  • NPI 1841873924
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Mary Goff Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Pineville, LA
  • NPI 1871281675
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Cherokee Elementary School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1891360756
  NPD tax ID
• Winn Community Health Center, Inc.

  dba South Grant Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Dry Prong, LA
  • NPI 1891559688
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Winn Community Health Center Pharmacy

  • Community/Retail Pharmacy
  • Winnfield, LA
  • NPI 1922508563
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Peabody School-Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1922599380
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Ruston Elementary SBC

  • Federally Qualified Health Center (FQHC)
  • Ruston, LA
  • NPI 1942183967
  NPD tax ID
• Winn Community Health Center, Inc.

  dba Poland Jr. High School Based Clinic

  • Federally Qualified Health Center (FQHC)
  • Alexandria, LA
  • NPI 1952046625
  NPD tax ID
• Winn Community Health Center, Inc.

  • Family Nurse Practitioner
  • Colfax, LA
  • NPI 1952785040
  NPD tax ID

Locations

All disclosed owners & managing parties 11

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

All facility ownership & control disclosures 22

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 1

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.

• Mallorie McDowell Parham, PA-C

  • Physician Assistant
  • Pineville, LA
  • NPI 1225685886
  NPD (past)

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589414400000",
    "number": "1972125813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1288",
            "city": "WINNFIELD",
            "state": "LA",
            "postal_code": "714831288",
            "telephone_number": "318-209-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 VANCE AVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713016059",
            "telephone_number": "318-648-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WINN COMMUNITY HEALTH CENTER, INC.",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-648-0375"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolton High School Based Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Winn Community Health Center, Inc. (Mabel Brasher Elementary School Based Clinic)
• Winn Community Health Center, Inc. (Arthur F. Smith Middle Magnet School Based Clinic)
• Winn Community Health Center, Inc. (Cherokee Elementary School Based Clinic)
• Winn Community Health Center, Inc. (Peabody School-Based Clinic)
• Winn Community Health Center, Inc. (Poland Jr. High School Based Clinic)
• Darnel Raeshawn Winns
• Maggye Rebecca Winterer
• Chloe Victoria Wise
• Christian J Wold, M.D.
• Howard G Wold, M.D.

• Federally Qualified Health Center (FQHC) in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Federally Qualified Health Center (FQHC) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.