Women's Medical & Surgical Clinic, Inc.

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

WOMEN'S MEDICAL & SURGICAL CLINIC, INC.

Doing business as

Mamou Ob.Gyn. & Family Health Center

Practice address

805 Cherry St
Mamou, LA 70554-2223

Phone

(337) 468-2250

Fax

(337) 468-2702

NPI assigned

May 19, 2016

Last updated

Mar 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Medha Upendra Kulkarni, C.P.A., J.D.

Title

Administrator

Phone

(337) 459-0481

Specialties & licenses 1

Addresses

Other names 1

• Mamou Ob.Gyn. & Family Health Center 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 1972950996. Details of each certification follow.

• CCN 193959 Rural health clinic · Active · Details

Rural health clinic certification: CCN 193959

Legal name

WOMENS MEDICAL & SURGICAL CLINIC, INC.

Doing business as

MAMOU OB.GYN. & FAMILY HEALTH CENTER

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

May 4, 2020

Last certification

May 4, 2026

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Aug 1, 1986 in LA

Enrollment address

805 Cherry St
Mamou, LA 70554-2223

Other NPIs with the same Medicare PAC ID 1

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

• Women's Medical & Surgical Clinic, Inc.

  • Obstetrics & Gynecology Physician
  • Mamou, LA
  • NPI 1447483110

  6406996602

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Mamou OB GYN Family Health Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Women's Medical & Surgical Clinic, Inc.

  • Obstetrics & Gynecology Physician
  • Mamou, LA
  • NPI 1447483110
  NPD tax ID

Locations

All disclosed owners & managing parties 5

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

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Katie Brooke Deshotel, APRN WHNP

  • Nurse Practitioner
  • Mamou, LA
  • NPI 1205343183

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Upendra M Kulkarni, M.D.

  • Obstetrics & Gynecology Physician
  • Mamou, LA
  • NPI 1750311478

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Practitioners 3

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.

• Katie Brooke Deshotel, APRN WHNP

  • Nurse Practitioner
  • Mamou, LA
  • NPI 1205343183
  NPD
• Upendra M Kulkarni, M.D.

  • Obstetrics & Gynecology Physician
  • Mamou, LA
  • NPI 1750311478
  NPD
• Kaitlyn Maricle

  • Family Nurse Practitioner
  • Oakdale, LA
  • NPI 1023804127
  NPD (past)

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

{
    "created_epoch": "1463616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520294400000",
    "number": "1972950996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CHERRY ST",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "705542223",
            "telephone_number": "337-468-2250",
            "fax_number": "337-468-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 CHERRY ST",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "705542223",
            "telephone_number": "337-468-2250",
            "fax_number": "337-468-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S MEDICAL & SURGICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-19",
        "last_updated": "2018-03-06",
        "status": "A",
        "authorized_official_last_name": "KULKARNI",
        "authorized_official_first_name": "MEDHA",
        "authorized_official_middle_name": "UPENDRA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-459-0481",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C.P.A., J.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mamou Ob.Gyn. & Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thrifty Way Pharmacy of Mamou LLC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-3755)
• Wheelchair Equipment and Bracing Specialists LLC
• Women's Clinic of Oakdale, L.L.C. (The Mamou OB-GYN Clinic)
• Women's Medical & Surgical Clinic, Inc.

• Rural Health Clinic/Center in Mamou, LA
• Providers in Mamou, LA by specialty
• Rural Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2018; 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.
• 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.