ALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC
NPI 1073267076
Clinic/Center - Rural Health in Dequincy, LA

Q: What is Allegiance Medical Clinic Of Dequincy LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since February 08, 2022CLIA 19D0944746 · Waiver

601 W 4TH ST, DEQUINCY, LA 70633(337) 786-6161(337) 786-7999 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 19, 2024, Jul 19, 2022, Feb 8, 2022 (3 updates tracked since 2022).

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About Allegiance Medical Clinic Of Dequincy Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC (NPI 1073267076) is a healthcare organization registered as a rural health in Dequincy, Louisiana and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through April 19, 2028 and lists Renee Michelle Willis, Clinic Manager, as its authorized official.

NPPES Registry Identity

NPI1073267076

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameALLEGIANCE MEDICAL CLINIC OF DEQUINCY LLC

Location Address601 W 4TH STDequincy, LA 70633-3301

Mailing Address601 W 4th StDequincy, LA 70633-3301 · (337) 786-6161 · Fax (337) 786-7999

Phone(337) 786-6161

Fax(337) 786-7999

Organization SubpartNo

Authorized OfficialRenee Michelle WillisClinic Manager · (337) 786-1271

Enumeration DateFebruary 8, 2022

Last NPPES UpdateSeptember 19, 20243 updates tracked since enumeration

NPPES CertifiedSeptember 19, 2024

✔ NPI 1073267076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedPodiatristTaxonomy 213E00000X

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X

Also ListedNurse Practitioner · PediatricsTaxonomy 363LP0200X

601 W 4TH ST, Dequincy, LA 70633

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D0944746

Allegiance Medical Clinic Of Dequincy · Dequincy, LA

Active · expires Apr 19, 2028

CLIA Number19D0944746

Laboratory TypePhysician Office

Certificate Effective DateApril 20, 2026

Certificate Expiration DateApril 19, 2028

Laboratory DirectorJalal Joudeh

Laboratory Phone(337) 786-6161

Laboratory LocationAllegiance Medical Clinic Of Dequincy601 West 4th Street, Dequincy, LA 70633

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLER RYAN HEXT

Registered Nurse (General Practice)