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KENTWOOD FAMILY CLINIC LLC
NPI 1780050294
Clinic/Center - Rural Health in Kentwood, LA

Active since August 19, 2015CLIA 19D2103494 · Waiver
919 AVENUE G, KENTWOOD, LA 70444(337) 991-9276(337) 991-9288 Get Directions Write a Review

NPPES record last updated: March 2, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kentwood Family Clinic Llc NPPES

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

KENTWOOD FAMILY CLINIC LLC (NPI 1780050294) is a healthcare organization registered as a rural health in Kentwood, Louisiana and active in the NPI registry since August 2015. The organization holds a CLIA Waiver certificate valid through October 13, 2027 and lists Nicole Howard, Ceo, as its authorized official.

NPPES Registry Identity

NPI1780050294
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameKENTWOOD FAMILY CLINIC LLC
Location Address919 AVENUE GKentwood, LA 70444
Mailing Address1509 Dulles DrLafayette, LA 70506-3718 · (337) 991-9276 · Fax (337) 991-9288
Phone(337) 991-9276
Fax(337) 991-9288
Organization SubpartNo
Authorized OfficialNicole HowardCeo · (337) 991-9276
Enumeration DateAugust 19, 2015
Last NPPES UpdateMarch 2, 2020
NPPES CertifiedMarch 2, 2020
✔ NPI 1780050294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
919 AVENUE G, Kentwood, LA 70444
Open in Google Maps ↗

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 19D2103494

Kentwood Family Clinic LLC · Kentwood, LA
Active · expires Oct 13, 2027
CLIA Number19D2103494
Laboratory TypePractitioner Other
Certificate Effective DateOctober 14, 2025
Certificate Expiration DateOctober 13, 2027
Laboratory DirectorBryan D. Tate
Laboratory Phone(337) 991-9276
Laboratory LocationKentwood Family Clinic LLC919 Avenue G, Kentwood, LA 70444
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 2

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

BRYAN D. TATE JR. FNP-C
Nurse Practitioner
919 AVENUE G
KENTWOOD, LA 70444
Tangipahoa Parish (985) 229-0202
ABIGAYLE CLAIRE SCULLY
Student in an Organized Health Care Education/Training Program
919 AVENUE G
KENTWOOD, LA 70444
Tangipahoa Parish (985) 229-0202

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 Kentwood Family Clinic LLC's NPI number?

The NPI number for Kentwood Family Clinic LLC is 1780050294. It was assigned to this organization in the NPPES registry on August 19, 2015.

Where is Kentwood Family Clinic LLC located?

Kentwood Family Clinic LLC is located at 919 Avenue G, Kentwood, LA 70444. The listed phone number is (337) 991-9276.

What is Kentwood Family Clinic LLC's specialty?

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

Does Kentwood Family Clinic LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D2103494) is associated with this NPI, valid through October 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kentwood Family Clinic LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Magnolia Health, Ambetter from Superior HealthPlan and Blue Cross and Blue Shield of Louisiana and 2 other insurers list Kentwood Family Clinic 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 Kentwood Family Clinic LLC was last updated on March 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.