PROVIDENCE PRIMARY CARE, LLC
NPI 1386238525
Nurse Practitioner - Primary Care in Bossier City, LA

Active since February 28, 2021CLIA 19D2233243 · Waiver
1000 CHINABERRY DR STE 1002, BOSSIER CITY, LA 71111(318) 562-3911(318) 656-3761 Get Directions Write a Review

NPPES record last updated: February 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 8, 2026, Jan 31, 2026, Mar 1, 2021 (3 updates tracked since 2021).

About Providence Primary Care, Llc NPPES

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

PROVIDENCE PRIMARY CARE, LLC (NPI 1386238525), doing business as Providence Primary Care, is a healthcare organization registered as a primary care in Bossier City, Louisiana and active in the NPI registry since February 2021. The organization holds a CLIA Waiver certificate valid through August 19, 2027, maintains a secondary practice location in Shreveport, and lists Lindsey Marlowe Rodgers, Owner, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1386238525
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NamePROVIDENCE PRIMARY CARE, LLC
Location Address1000 CHINABERRY DR STE 1002Bossier City, LA 71111-2463
Mailing Address1000 Chinaberry Dr Ste 1002Bossier City, LA 71111-2463 · (318) 562-3911 · Fax (318) 656-3761
Fax(318) 656-3761
Organization SubpartNo
Authorized OfficialLindsey Marlowe RodgersOwner, Nurse Practitioner · (318) 562-3911
Enumeration DateFebruary 28, 2021
Last NPPES UpdateFebruary 8, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 8, 2026
NPI 1386238525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X
1000 CHINABERRY DR STE 1002, Bossier City, LA 71111

Other Names 1

Doing Business AsProvidence Primary Care

Secondary Practice Location 1

Location 12120 Bert Kouns Industrial Loop Ste FShreveport, LA 71118-3354 · Phone (318) 562-3911 · Fax (318) 301-8464

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

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 19D2233243

Providence Primary Care, LLC · Bossier City, LA
Active · expires Aug 19, 2027
CLIA Number19D2233243
Laboratory TypePractitioner Other
Certificate Effective DateAugust 20, 2025
Certificate Expiration DateAugust 19, 2027
Laboratory DirectorLindsey M. Fortenberry
Laboratory Phone(318) 562-3911
Laboratory LocationProvidence Primary Care, LLC1000 Chinaberry Drive, Suite 1002, Bossier City, LA 71111
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

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

Nurse Practitioner (Family)
1000 CHINABERRY DR STE 1002
BOSSIER CITY, LA 71111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Primary Care, LLC's NPI number?

The NPI number for Providence Primary Care, LLC is 1386238525. It was assigned to this organization in the NPPES registry on February 28, 2021. The provider is doing business as Providence Primary Care.

Where is Providence Primary Care, LLC located?

Providence Primary Care, LLC is located at 1000 Chinaberry Dr Ste 1002, Bossier City, LA 71111. The listed phone number is (318) 562-3911.

What is Providence Primary Care, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Providence Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D2233243) is associated with this NPI, valid through August 19, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Providence Primary Care, LLC accept?

Health plans from Blue Cross and Blue Shield of Louisiana and HMO Louisiana list Providence Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Providence Primary Care, LLC was last updated on February 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.