Allen'S Family Practice Clinic of Ponchatoula, L.L.P.

Organization Active NPI Family Medicine Physician · Ponchatoula, LA

NPI 1992793095 · NPPES record last updated Jul 2, 2026

Key facts

NPI
1992793095
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
ALLEN'S FAMILY PRACTICE CLINIC OF PONCHATOULA, L.L.P.
Practice address
105 E Oak St
Ponchatoula, LA 70454-2619
Phone
(985) 386-6198
Fax
(985) 386-6223
NPI assigned
Oct 12, 2005
Organization subpart
No

Authorized official

Name
Mrs. Cathy L. Allen
Title
Clinic Manager
Phone
(985) 386-6198

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D0718793Allen'S Family Practice
105 East Oak St, Ponchatoula, LA 70454
Certificate of waiverFeb 15, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071120000123 LA Part B Supplier - Clinic/Group Practice 9032207360 Receives reassigned benefits from 2 practitioners
Practice locations: Ponchatoula, LA

National Provider Directory

Locations

800 S Oak St
Hammond, LA 70403
Phone (504) 615-6419

105 E Oak St
Ponchatoula, LA 70454
Phone (504) 386-6198

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71800

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

105 E Oak St
Ponchatoula, LA 70454-2619

Mailing address

PO Box 129
Ponchatoula, LA 70454-0129
Phone (985) 386-6198

Other identifiers

IdentifierTypeStateIssuer
1950009MedicaidLA

Other providers in Ponchatoula, LA

All providers in Ponchatoula, LA · Family Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.