Anna Fontenot Medical Center LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ANNA FONTENOT MEDICAL CENTER LLC

Doing business as

Magnolia Therapeutics

Practice address

724 W Magnolia St
Ville Platte, LA 70586-4320

Phone

(337) 506-2294

NPI assigned

Nov 3, 2021

Last updated

Nov 8, 2021By 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

Anna Thevenot FontenotNPI 1962716258

Title

Ceo

Phone

(337) 363-5531

Specialties & licenses 1

Addresses

Other names 1

• Magnolia Therapeutics Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Tax ID family

Anna Fontenot Medical Center LLC2 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.

• Vital Healthcare Solutions LLC

  dba Magnolia Therapeutics

  • Rural Health Clinic/Center
  • Ville Platte, LA
  • NPI 1598473415
  NPD tax ID

Change-of-ownership history 1

Change of ownership 1

Medicare changes of ownership in which this facility was the buyer or the seller.

• Vital Healthcare Solutions LLC

  dba Magnolia Therapeutics

  • Rural Health Clinic/Center
  • Ville Platte, LA
  • NPI 1598473415

  Sold to, 2022-09-06

  CMS change of ownership

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.

• Anna Thevenot Fontenot, APRN

  • Family Nurse Practitioner
  • Ville Platte, LA
  • NPI 1962716258
  Authorized official Same address or phone

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1982369096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 W MAIN ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705864208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 W MAGNOLIA ST",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705864320",
            "telephone_number": "337-506-2294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA FONTENOT MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "FONTENOT",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "THEVENOT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-363-5531"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Therapeutics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Therapeutics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michelle Allison
• Dodanim Francisco Altamirano, MD
• Eduardo L Alvarez, M.D.
• Denise Anderson
• Anna Fontenot Medical Center LLC (Dupre Medical Clinic)
• Denise Watkins Antoine
• Jean Batiste Ardoin, BEHAVIOR TECHNICIAN
• Leeanne Sonnier Ardoin, FNP
• Lionel Ted Ardoin, DDS
• Philip B Ardoin

• Rural Health Clinic/Center in Ville Platte, LA
• Providers in Ville Platte, 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 Nov 8, 2021; 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.