community care pcp linkage report...phy 2552 5000 ages 0 - 18; curr pts 19 - 20 ccpcplinkage_public...
TRANSCRIPT
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
JEFFERSON AVONDALE JEFFERSON COMMUNITY HEALTHCARE 4028 US HWY 90 AVONDALE, LA 70094(504) 436-2223
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
845 5500 AGES 0 - 64
GRETNA BOUCHETTE ALIX 230 MEADOWCREST ST GRETNA, LA 70056(504) 392-5997
PHY FAMILY PRACTICE 1094 2500 AGES 0 - 64
DANG THIEM 1221 AMELIA STREET GRETNA, LA 70053(504) 364-1844
PHY FAMILY PRACTICE 415 2500 AGES 21 - 64
FISHER MARC 12 A WESTBANK EXPWY, SUITE 100 GRETNA, LA 70053(504) 361-0234
PHY PEDIATRICS 1002 2500 AGES 0 - 20
FORTINO JAMES 1301 WHITNEY AVE GRETNA, LA 70056(504) 367-8777
PHY PEDIATRICS 1013 2500 AGES 0 - 20
GROWING UP CHILDRENS CLINIC 120 MEADOWCREST ST., SUITE 470 GRETNA, LA 70056(504) 392-2580
PHY CLINIC OR OTHER GROUP PRACTICE
1087 2500 AGES 0 - 17
MICHAEL HAYDEL MD AMC - GRETNA 120 MEADOWCREST ST STE 100GRETNA, LA 70056(504) 391-7565
PHY 2507 2500 AGES 0 - 20
NGUYEN HAI NAM 1221 AMELIA STREET GRETNA, LA 70053(504) 364-1844
PHY INTERNAL MEDICINE 1191 2500 AGES 0 - 20
PEDIATRIC CLINIC - WESTBANK 151 MEADOWCREST ST. STE. F GRETNA, LA 70056(504) 392-9298
PHY CLINIC OR OTHER GROUP PRACTICE
5519 7500 AGES 0 - 17
PEDIATRIC KIDMED LLC 120 MEADOWCREST ST., STE. 245 GRETNA, LA 70056(504) 391-7690
PHY CLINIC OR OTHER GROUP PRACTICE
3713 7500 AGES 0 - 16
VALENTINE MEDICAL CENTER 1620 BELLE CHASSE HWY GRETNA, LA 70056(504) 363-4711
PHY CLINIC OR OTHER GROUP PRACTICE
986 3000 AGES 0 - 64
HARVEY LE CAC 851 MANHATTAN BLVD STE AHARVEY, LA 70058(504) 368-4396
PHY GENERAL PRACTICE 1575 2500 AGES 0 - 18
Page Number: 1CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
JEFFERSON HARVEY TRUYEN T. VU APMC 3709 WESTBANK EXPWY STE 1BHARVEY, LA 70058(504) 348-2310
PHY CLINIC OR OTHER GROUP PRACTICE
1673 5000 AGES 0 - 20
MARRERO ALFEREZ TLALOC 4700 WICHERS DRIVE, SUITE 304 MARRERO, LA 70072(504) 644-4787
PHY INTERNAL MEDICINE 326 2500 AGES 21 - 64
CHILDREN'S MEDICAL CLINIC 829 BARATARIA BLVD MARRERO, LA 70072(504) 368-7337
PHY CLINIC OR OTHER GROUP PRACTICE
2873 5000 AGES 0 - 20
JEFFERSON COMMUNITY HEALTH CARE
1855 AMES BLVD, SUITE B MARRERO, LA 70072(504) 341-4006
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
510 6000 AGES 0 - 64
JEFFERSON PEDIATRIC CLINIC 1111 MEDICAL CTR BLVD, N813 MARRERO, LA 70072(504) 349-6813
PHY CLINIC OR OTHER GROUP PRACTICE
1692 2500 CURRENT PATIENTS AGES 0 - 20
MICHAEL G RUSSO MD A PROFESSIONAL MEDICAL CORPORATION
1111 MEDICAL CENTER BLVD S-555MARRERO, LA 70072(504) 367-8577
PHY CLINIC OR OTHER GROUP PRACTICE
578 2500 AGES 21 - 64
MICHAEL HAYDEL MD AMC - MARRERO 1111 MEDICAL CENTER BLVD #N208 MARRERO, LA 70072(504) 349-6228
PHY 1930 2500 AGES 0 - 20
PRAMELA GANJI MD APMC 1301 BARATARIA BLVD MARRERO, LA 70072(504) 347-8253
PHY CLINIC OR OTHER GROUP PRACTICE
578 2500 AGES 21- 64
REMEDIOS OTHOLINO 1111 MED CTR BLVD, SUITE S-650 MARRERO, LA 70072(504) 347-0202
PHY PEDIATRICS 547 2500 AGES 0 - 20
TURNER JULES 4700 WICHERS DRIVE, SUITE 101 MARRERO, LA 70072(504) 371-0676
PHY PEDIATRICS 670 2500 AGES 0 - 20
WESTCARE MEDICAL CENTER 1220 BARATARIA BOULEVARD MARRERO, LA 70072(504) 340-6711
PHY 2449 5500 AGES 0 - 64
WESTSIDE CLINICS AMC 7017 LAPALCO BLVD. MARRERO, LA 70072(504) 391-7337
PHY 4958 5000 AGES 0 - 20
Page Number: 2CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
JEFFERSON MARRERO WESTSIDE CLINICS AMC 4225 LAPALCO BLVD. MARRERO, LA 70072(504) 391-7337
PHY 2964 20000 AGES 0 - 20
WESTWEGO WESTCARE MEDICAL CENTER 712 WESTBANK EXPRESSWAY WESTWEGO, LA 70094(504) 340-7744
PHY 1968 3500 AGES 0 - 64
ORLEANS NEW OLREANS
DAO MINH 4657 ALCEE FORTIER BLVD,STE A NEW OLREANS, LA 70129(504) 254-4011
PHY GENERAL PRACTICE 1606 2500 AGES 0 - 64
NEW ORLEANS
ADVANCED CLINICAL CONSULT 3134 CALHOUN STREET, SUITE A NEW ORLEANS, LA 70125(504) 861-0108
PHY CLINIC OR OTHER GROUP PRACTICE
151 1000 AGES 21 - 64
ALGIERS COMMUNITY HEALTH CLINIC 1111 NEWTON ST 1ST FLOORNEW ORLEANS, LA 70114(504) 658-2550
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1214 2500 AGES 0 - 64
BARNES JANET 3600 PRYTANIA ST STE 50NEW ORLEANS, LA 70115(504) 891-1800
PHY PEDIATRICS 1435 2500 AGES 0 - 20
BARNES SHELTON 3600 PRYTANIA ST STE 50NEW ORLEANS, LA 70115(504) 891-1800
PHY INTERNAL MEDICINE 422 2500 AGES 15 - 64
BAWA GURMUKH 1553 N BROAD STREET NEW ORLEANS, LA 70119(504) 943-9222
PHY GENERAL PRACTICE 1159 2500 AGES 2 - 64
CAPONE KEITH 6517 SPANISH FORT BLVD NEW ORLEANS, LA 70124(504) 283-7306
PHY 88 100 CLOSED PANEL
CHILDREN'S HOSPITAL MEDICAL PRACTICE CO
3600 PRYTANIA STE. 100 NEW ORLEANS, LA 70115(504) 899-5437
PHY 3753 7500 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CO
2820 NAPOLEAN AVE, STE 950 NEW ORLEANS, LA 70115(504) 897-4242
PHY 3206 5000 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
1661 CANAL STREET,STE 1200 NEW ORLEANS, LA 70112(504) 299-9980
PHY 2552 5000 AGES 0 - 18; CURR PTS 19 - 20
Page Number: 3CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ORLEANS NEW ORLEANS
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
4052 ULLOA ST NEW ORLEANS, LA 70119(504) 488-7505
PHY 1592 2500 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
14401 CHEF MENTEUR HWY NEW ORLEANS, LA 70129(504) 662-0644
PHY 945 2500 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
3512 LOUISA STREET NEW ORLEANS, LA 70126(504) 948-2873
PHY 501 2500 AGES 0 - 20
CHILDRENS CLINIC OF NEW ORLEANS 3201 GENERAL MEYER AVE. STE. C NEW ORLEANS, LA 70114(504) 362-8930
PHY 2555 5000 AGES 0 - 20
CHILDRENS CLINIC OF NEW ORLEANS 2101 BANKS STREET NEW ORLEANS, LA 70112(504) 523-4357
PHY 553 5000 AGES 0 - 20
CITY OF NEW ORLEANS EAST FAMILY HHC
5640 READ BLVD STE 540NEW ORLEANS, LA 70127(504) 658-2750
PHY CLINIC OR OTHER GROUP PRACTICE
747 5000 AGES 0 - 64
CITY OF NEW ORLEANS-EDNA PILSBURY HEALTH CLINIC
2222 SIMON BOLIVAR AVE 2ND FLNEW ORLEANS, LA 70113(504) 658-2825
PHY CLINIC OR OTHER GROUP PRACTICE
1467 5000 AGES 0 - 64
CRESCENT CITY PEDIATRICS 320 N CARROLLTON AVE STE 103NEW ORLEANS, LA 70119(504) 486-5151
PHY CLINIC OR OTHER GROUP PRACTICE
2770 5000 AGES 0 - 18
CRESCENT CITY PHYSICIANS INC 3434 PRYTANIA ST,#460 NEW ORLEANS, LA 70115(504) 897-7999
PHY 264 800 LIMITED PANEL; AGES 14 - 64
CRESCENT CITY PHYSICIANS INC 3434 PRYTANIA ST STE 430NEW ORLEANS, LA 70115(504) 897-8118
PHY 1064 10000 AGES 14 - 64
CRESCENT CITY PHYSICIANS INC 3322 ST. CLAUDE AVE NEW ORLEANS, LA 70117(504) 947-7754
PHY 807 2500 AGES 14 - 64
CRESCENT CITY PHYSICIANS INC 3712 MACARTHUR BLVD, SUITE 200 NEW ORLEANS, LA 70114(504) 367-6971
PHY 193 2500 CURRENT PATIENTS AGES 14 - 64
Page Number: 4CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ORLEANS NEW ORLEANS
CRESCENT CITY PHYSICIANS INC 9801 LAKE FORREST BLVD NEW ORLEANS, LA 70127(504) 246-1452
PHY 153 300 CLOSED PANEL
CRESCENT CITY PHYSICIANS INC 3434 PRYTANIA ST STE 110NEW ORLEANS, LA 70115(504) 897-7007
PHY 96 100 AGES 14 - 64
CRESCENT CITY PHYSICIANS INC 145 ROBERT E LEE BLVD STE 402NEW ORLEANS, LA 70124(504) 304-7949
PHY 210 2500 AGES 14 - 64
DAUGHTERS OF CHARITY HEALTH CLINIC
4201 N RAMPART STREET NEW ORLEANS, LA 70117(504) 941-6041
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
336 7500 AGES 0 - 64
DAUGHTERS OF CHARITY HEALTH CLINIC
3201 S CARROLLTON AVENUE NEW ORLEANS, LA 70119(504) 207-3060
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
834 16000 AGES 0 - 64
DYER JEAN 3405 ST. CLAUDE AVENUE NEW ORLEANS, LA 70117(504) 943-9578
PHY CARDIOVASCULAR DISEASE, INTERNAL MEDICINE
105 2500 AGES 21 - 64
FLOYD FREDRICK 2909 ST CLAUDE AVENUE NEW ORLEANS, LA 70117(504) 942-1167
INTERNAL MEDICINE 494 2500 AGES 21 - 64
GALVEZ DOCTORS CLINIC 1407 PIETY STREET NEW ORLEANS, LA 70117(504) 940-0820
PHY CLINIC OR OTHER GROUP PRACTICE
889 2500 AGES 0 - 64
GARAUDY ANDREA 6517 SPANISH FORT BLVD NEW ORLEANS, LA 70124(504) 283-7306
PHY 113 100 CLOSED PANEL; LIMITED PANEL; AGES 0 - 20
HACKETT JUDITH 1901 LEONIDAS ST NEW ORLEANS, LA 70118(504) 865-1539
PHY FAMILY PRACTICE 796 2500 AGES 0 - 64
HUNTER MICHAEL 2714 CANAL ST, SUITE 201 NEW ORLEANS, LA 70119(504) 822-1092
PHY FAMILY PRACTICE 393 2500 AGES 21 - 64
LIN EDWIN 4209 ST. CLAUDE AVE. NEW ORLEANS, LA 70117(504) 944-0144
PHY 2124 2500 AGES 0 - 20
Page Number: 5CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ORLEANS NEW ORLEANS
LOUISIANA AVENUE MEDICAL CENTER INC
4301 ELYSIAN FIELDS AVENUE NEW ORLEANS, LA 70122(504) 284-3866
PHY CLINIC OR OTHER GROUP PRACTICE
1287 3500 AGES 0 - 64
LSU BAPTIST UPTOWN 2820 NAPOLEON AVE STE 890NEW ORLEANS, LA 70115(504) 412-1366
PHY 1001 2500 AGES 0 - 64
LSU MEDICINE CLINIC AT LORD & TAYLOR
1450 POYDRAS ST 3RD FLOORNEW ORLEANS, LA 70115(504) 903-2373
PHY 659 5000 AGES 21 - 64
MACARTHUR PRIMARY CARE CENTER 3712 MACARTHUR BLVD, STE 202 NEW ORLEANS, LA 70114(504) 368-4066
PHY CLINIC OR OTHER GROUP PRACTICE
134 500 LIMITED PANEL; CURR PTS & FAMILY MEMBERS AGES 0-64
MADISON EDWARD 9511 CHEF MENTEUR HWY, STE 106 NEW ORLEANS, LA 70127(504) 241-0861
PHY PEDIATRICS 13 2500
MCLNO HOP CLINIC 136 S ROMAN STREET, 4TH FLOOR NEW ORLEANS, LA 70112(504) 903-6959
PHY 301 3500 AGES 21 - 64
MCLNO-MARTIN BEHRMAN 715 OPELOUSAS AVE NEW ORLEANS, LA 70114(504) 361-6440
PHY 739 5500 AGES 0 - 64
MCLNO/TULANE HOSPITAL PEDIATRICS/ADOLESCENT
136 S.ROMAN ST.4TH FL MC CLINI NEW ORLEANS, LA 70112(504) 903-6959
PHY 15 2500 AGES 0 - 24
MCLNO/TULANE MEDICINE GROUP 1450 POYDRAS AVE., 3RD FLOOR NEW ORLEANS, LA 70112(504) 988-2618
PHY 215 5000 AGES 21 - 64
MCNEIL KIMBERLY 8736 CHEF MENTEUR HWY, SUITE 1 NEW ORLEANS, LA 70127(504) 244-0022
PHY PEDIATRICS 1327 2500 AGES 0 - 20
MEDICAL SPECIALISTS OF TOURO 3525 PRYTANIA ST STE 220NEW ORLEANS, LA 70115(504) 897-4017
PHY CLINIC OR OTHER GROUP PRACTICE
345 5000 AGES 21 - 64, NOT AFFILIATED WITH TOURO INFIRMARY
MIDTOWN MEDICAL LLC 3500 ST. CHARLES AVE SUITE 100NEW ORLEANS, LA 70115(504) 895-0990
PHY CLINIC OR OTHER GROUP PRACTICE
668 7500 WOMEN ONLY AGES 21 - 60
Page Number: 6CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ORLEANS NEW ORLEANS
MOLDEN GREGORY 2121 MAGAZINE ST NEW ORLEANS, LA 70130(504) 592-9818
PHY GENERAL PRACTICE 316 2500 AGES 21 - 64
NO/AIDS TASK FORCE 2601 TULANE AVE STE 500NEW ORLEANS, LA 70119(504) 821-2601
PHY CLINIC OR OTHER GROUP PRACTICE
85 3500 AGES 18 - 64
NOHC-CENTRAL CITY 2222 SIMON BOLIVAR 1ST. FLOOR NEW ORLEANS, LA 70113(504) 571-1607
PHY CLINIC OR OTHER GROUP PRACTICE
1352 5000 AGES 0 - 64
NOHD HEALTHCARE FOR THE HOMELESS
2222 SIMON BOLIVAR 2ND FLOORNEW ORLEANS, LA 70113(504) 658-2785
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
29 100 LIMITED PANEL; AGES 21 - 64
OCHSNER MEDICAL CENTER FOR CHILDREN MAIN CAMPUS
1315 JEFFERSON HWY NEW ORLEANS, LA 70121(504) 842-3900
PHY 1619 17500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 17
OGBUOKIRI GODWIN 4543 DOWNMAN ROAD NEW ORLEANS, LA 70126(504) 246-5227
PHY GENERAL SURGERY 798 2500 AGES 6 - 64
PEDIATRIC ASSOCIATES OF NEW ORLEANS
4511 DOWMAN ROAD NEW ORLEANS, LA 70126(504) 245-4000
PHY CLINIC OR OTHER GROUP PRACTICE
2208 2500 AGES 0 - 20; ACCEPTING NEW PTS AGES 0 - 18 ONLY
SINGLETON RENEE 5951 BULLARD AVENUE, SUITE 8 NEW ORLEANS, LA 70128(504) 241-4040
PHY FAMILY PRACTICE 30 2500
ST THOMAS COMMUNITY HEALTH CENTER
1020 ST ANDREW ST NEW ORLEANS, LA 70130(504) 529-5558
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1303 10000 AGES 0 - 64
TANGPRICHA VITHAVAS 4209 ST. CLAUDE AVE. NEW ORLEANS, LA 70117(504) 944-0144
PHY 2018 2500 AGES 0 - 17
TILLERY-JR BERTRAND 3500 BEHRMAN PLACE STE 200 NEW ORLEANS, LA 70114(504) 365-9906
PHY GENERAL PRACTICE, FAMILY PRACTICE
1226 2500 AGES 0 - 64
TUHC FAMILY HEALTH WITH OBGYN 200 BROADWAY ST., STE 230 NEW ORLEANS, LA 70118(504) 988-9000
PHY 269 300 MATERNAL PTS & THEIR MINOR CHILDREN AGES 0 - 39
Page Number: 7CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ORLEANS NEW ORLEANS
TUHC MEDICAL PEDIATRICS CLINIC 275 LASALLE STREET NEW ORLEANS, LA 70112(504) 988-5030
PHY 1381 3000 AGES 0 - 64
TULANE DOWNTOWN GENERAL PEDIATRICS
1415 TULANE AVENUE 5TH FLOORNEW ORLEANS, LA 70112(504) 988-6253
PHY 666 2500 AGES 0 - 20
TULANE DROP-IN CLINIC AT COVENANT HOUSE
611 NORTH RAMPART ST NEW ORLEANS, LA 70112(504) 584-1112
PHY 555 2500 AGES 0 - 23
TULANE FAMILY PRACTICE 200 BROADWAY STE 230NEW ORLEANS, LA 70118(504) 988-9000
PHY 397 400 LIMITED PANEL; NO OB PATIENTS; AGES 0 - 64
TULANE GENERAL INTERNAL MEDICINE 275 LASALLE STREET NEW ORLEANS, LA 70112(504) 988-5030
PHY 18 2500 CLOSED PANEL
TULANE MEDICINE PEDIATRICS - UPTOWN
200 BROADWAY, SUITE 230 NEW ORLEANS, LA 70118(504) 988-9000
PHY 780 2500 AGES 0 - 20
TULANE UNIVERSITY COMMUNITY HEALTH CLINIC
611 N RAMPART ST NEW ORLEANS, LA 70112(504) 988-3000
PHY 423 10500 AGES 21 - 64
UPTOWN NEPHROLOGY 3525 PRYTANIA ST STE 620NEW ORLEANS, LA 70115(504) 897-4425
PHY CLINIC OR OTHER GROUP PRACTICE
10 7500 CURRENT PATIENTS AGES 21 - 64
WESTBANK PHYSICIAN ASSOCIATES 3439 KABEL DRIVE STE 8NEW ORLEANS, LA 70131(504) 433-9720
PHY CLINIC OR OTHER GROUP PRACTICE
130 2500 CURRENT PATIENTS AGES 21 - 64
PLAQUEMINES BELLE CHASSE
BELLE CHASSE FAMILY MEDICAL CENTER
8200 HWY 23 BELLE CHASSE, LA 70037(504) 398-1100
PHY CLINIC OR OTHER GROUP PRACTICE
504 5000 AGES 6 - 64
US MEDCARE LLC 7682 HIGHWAY 23 STE BBELLE CHASSE, LA 70037(504) 433-3363
PHY CLINIC OR OTHER GROUP PRACTICE
154 5000 AGES 21 - 64
ST. BERNARD CHALMETTE CHILDREN'S INTERNATIONAL 705 E JUDGE PEREZ DR CHALMETTE, LA 70043(504) 279-5547
PHY 921 3000 AGES 0 - 17
Page Number: 8CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. BERNARD CHALMETTE FAMILY HEALTH CARE CLINIC 8301 W JUDGE PEREZ DR STE 207CHALMETTE, LA 70043(504) 278-1884
PHY CLINIC OR OTHER GROUP PRACTICE
413 1000 AGES 0 - 64
LIN EDWIN 221 WEST GENIE STREET CHALMETTE, LA 70043(504) 277-7634
PHY 484 2500 AGES 0 - 20
ST BERNARD HEALTH CENTER INC 8101 W JUDGE PEREZ DR CHALMETTE, LA 70043(504) 281-2800
PHY CLINIC OR OTHER GROUP PRACTICE
2718 7500 AGES 0 - 64
TANGPRICHA VITHAVAS 221 WEST GENIE ST CHALMETTE, LA 70043(504) 277-7634
PHY 453 2500 AGES 0 - 18
EAST JEFFERSON
KENNER ARA ANJUMAN 200 W. ESPLANADE AVE STE 312KENNER, LA 70065(504) 712-8872
PHY INTERNAL MEDICINE 132 2500 AGES 21 - 64
CERRATO CIRO 3814 WILLIAMS BLVD KENNER, LA 70065(504) 465-0115
PHY CARDIOVASCULAR DISEASE
194 2500 AGES 21 - 64
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
3321 FLORIDA AVENUE KENNER, LA 70065(504) 468-4437
PHY 507 2500 AGES 0 - 20
ESTARIS RAUL 3321 FLORIDA AVENUE KENNER, LA 70065(504) 465-0800
PHY INTERNAL MEDICINE 167 2500 AGES 21 - 64
GAUTREAUX-III JOSEPH 200 W ESPLANADE AVE SUITE 120KENNER, LA 70065(504) 464-8683
PHY GENERAL PRACTICE, OTOLOGY, LARYNGOLOGY, RHINOLOGY
194 2500 AGES 4 - 64
GELMAN VADIM 3555 LOYOLA DRIVE, SUITE D KENNER, LA 70065(504) 464-8750
PHY OB/GYN 34 2500 CLOSED PANEL
LSU FAMILY MEDICINE KENNER 200 W. ESPLANADE AVE.#412 KENNER, LA 70065(504) 471-2750
PHY 862 15000 AGES 0 - 64
LSU-KENNER MULTI SPECIALTY CLINIC 200 W. ESPLANADE AVE. STE 205KENNER, LA 70065(504) 412-1705
PHY 173 2500 AGES 18 - 64
Page Number: 9CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST JEFFERSON
KENNER MAYORGA CHRISTIAN 4228 WILLIAMS BLVD SUITE 201KENNER, LA 70065(504) 305-0063
PHY FAMILY PRACTICE 121 2500 AGES 21 - 64
MENDOZA ROBERT 3100 WILLIAMS BLVD. KENNER, LA 70065(504) 443-5430
PHY PEDIATRICS 3530 2500 MAX CAPACITY EXCEEDED; AGES 0 - 20
PATEL HARSHAD 4216 FLORIDA AVENUE KENNER, LA 70065(504) 466-3702
PHY INTERNAL MEDICINE 149 2500 AGES 21 - 64
PEDIATRIC MEDICAL CLINIC 2400 VETERANS MEM BLVD STE 490KENNER, LA 70062(504) 305-3812
PHY 187 2500 AGES 0 - 20
PMA MEDICAL TREATMENT 613 WILLIAMS BLVD KENNER, LA 70062(504) 441-5555
PHY CLINIC OR OTHER GROUP PRACTICE
768 3000 AGES 6 MONTHS - 64 YEARS
QUYNH MAI CLINIC LLC 705 W ESPLANADE AVE SUITE AKENNER, LA 70065(504) 465-0185
PHY CLINIC OR OTHER GROUP PRACTICE
400 7500 AGES 21 - 64
RICHARDSON GLENDA 2100 THIRD STREET, STE. 6 KENNER, LA 70062(504) 466-1251
PHY PEDIATRICS 1141 2500 AGES 0 - 13
ROMAGUERA PEDRO 3800 HOUMA BLVD STE 350KENNER, LA 70006(504) 465-2223
PHY INTERNAL MEDICINE 222 2500 AGES 21 - 64
SAMUEL BROWN MD AMC 3813 WILLIAMS BLVD. KENNER, LA 70065(504) 443-5437
PHY CLINIC OR OTHER GROUP PRACTICE
4809 6500 AGES 0 - 20
SMITH VICTORIA 4228 WILLIAMS BLVD STE 203KENNER, LA 70065(504) 496-0138
PHY FAMILY PRACTICE 311 450 AGES 12 - 64
ST CHARLES COMMUNITY HEALTH CENTER
200 W ESPLANADE AVE #310-314 KENNER, LA 70065(504) 712-7800
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1328 5500 AGES 0 - 64
METAIRIE CAROUSEL PEDIATRICS APMC 4224 HOUMA BLVD STE 240METAIRIE, LA 70006(504) 885-4141
PHY CLINIC OR OTHER GROUP PRACTICE
338 500 LIMITED PANEL; CURRENT PTS & SIBLINGS AGES 0 - 20
Page Number: 10CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST JEFFERSON
METAIRIE CHILDREN'S HOSPITAL MEDICAL 4740 S. I-10 SERVICE RD METAIRIE, LA 70001(504) 883-3703
PHY 2758 17500 CURRENT PATIENTS AND NEWBORNS AGES 0 - 18
CHILDREN'S HOSPITAL MEDICAL PRACTICE CO
3040 33RD STREET METAIRIE, LA 70001(504) 219-0880
PHY 1877 15000 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
2201 VETERANS BLVD STE 300METAIRIE, LA 70002(504) 833-7374
PHY 2735 7500 ACCEPTS CURRENT PTS & SIBLINGS BIRTH TO 6 MONTHS
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
3100 KINGMAN STREET, SUITE 110 METAIRIE, LA 70006(504) 887-6355
PHY 761 2500 OPEN AGES 0 - 2 MNTHS; CURR PTS AGES 3MNTH - 17YRS
CHILDRENS CLINIC LLC 5037 VETERANS BLVD STE 2EMETAIRIE, LA 70006(504) 887-2616
PHY 1516 5000 AGES 0 - 18
DAUGHTERS OF CHARITY HEALTH CENTER
111 N CAUSEWAY BLVD METAIRIE, LA 70001(504) 482-0084
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
834 5500 AGES 0 - 64
DRS. LEBOEUF & BURAS AM 2800 VETERANS BLVD. SUITE 340 METAIRIE, LA 70002(504) 309-9364
PHY CLINIC OR OTHER GROUP PRACTICE
3259 7500 AGES 0 - 10
FAMILY PRACTICE CENTER 4228 HOUMA BLVD, SUITE 200 METAIRIE, LA 70006(504) 454-7878
PHY CLINIC OR OTHER GROUP PRACTICE
469 15000 ACCEPTS NEW PTS AGES 0-20, CURRENT PTS AGES 21-64
HAROLD R YORK MD APMC 4937 HEARST ST STE 2-AMETAIRIE, LA 70001(504) 885-9957
PHY CLINIC OR OTHER GROUP PRACTICE
1532 2500 AGES 0 - 20
LEVY LAWRENCE 3800 HOUMA BLVD #325 METAIRIE, LA 70006(504) 888-7111
PHY INTERNAL MEDICINE 1 1 AGES 21 - 64
NETWORK PHYSICIANS 4228 HOUMA BLVD STE 330METAIRIE, LA 70006(504) 456-5123
PHY CLINIC OR OTHER GROUP PRACTICE
1 7500 CLOSED PANEL
OCHSNER CHILDREN'S HEALTH CENTER
4901 VETERANS BLVD. METAIRIE, LA 70006(504) 887-1133
PHY 1262 18000 CURRENT PATIENTS, NEWBORNS, & SIBLINGS AGES 0 - 18
Page Number: 11CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST JEFFERSON
METAIRIE OKOLE SAMMY 5500 VETERANS BLVD STE 208METAIRIE, LA 70003(504) 887-7792
PHY FAMILY PRACTICE 124 2500 AGES 21 - 64
PARIKH PARIMAL 3800 HOUMA BLVD STE 308METAIRIE, LA 70006(504) 457-2577
PHY INTERNAL MEDICINE 154 2500 AGES 21 - 64
SUNNYSIDE PEDIATRICS LLC 4420 CONLIN STREET SUITE 205METAIRIE, LA 70006(504) 455-8887
PHY CLINIC OR OTHER GROUP PRACTICE
1982 5000 AGES 0 - 20
SUNRISE PEDIATRIC ASSOCIATES 3116 6TH ST,STE 101 METAIRIE, LA 70002(504) 837-9000
PHY 850 7500 CURRENT PATIENTS, NEWBORNS, & SIBLINGS AGES 0 - 20
TRAN MEDICAL ASSOCIATES 3848 VETERANS BLVD, SUITE 101 METAIRIE, LA 70002(504) 885-2505
PHY CLINIC OR OTHER GROUP PRACTICE
235 5000 CLOSED PANEL
TUHC GENERAL PEDIATRICS AT METAIRIE
4720 S I-10 SERVICE RD STE 501METAIRIE, LA 70001(504) 988-8000
PHY 1279 7500 AGES 0 - 20
TUHC METAIRIE CLINIC 4720 S I-10 SERVICE RD,STE 101 METAIRIE, LA 70001(504) 988-8050
PHY 9 300
TULANE CENTER FOR WOMENS HEALTH
4720 S 1-10 SVC RD W STE 300METAIRIE, LA 70001(504) 988-8070
PHY 382 5000 FEMALES ONLY, AGES 13 - 64
TULANE GENERAL PEDIATRICS 4720 I-10 SERVICE RD STE 501METAIRIE, LA 70001(504) 988-8000
PHY 864 5000 AGES 0 - 20
VOIGHT JACK 4428 CONLIN STREET, SUITE A METAIRIE, LA 70006(504) 883-8334
PHY GENERAL PRACTICE 593 2500 AGES 21 - 64
WILLIAM ST. JOHN LACORTE APMC 519 METAIRIE ROAD METAIRIE, LA 70005(504) 838-6000
PHY CLINIC OR OTHER GROUP PRACTICE
97 2500 CURRENT PATIENTS AGES 21 - 64
RIVER RIDGE CHILDREN'S HOSPITAL MEDICAL 9605 JEFFERSON HIGHWAY RIVER RIDGE, LA 70123(504) 738-1604
PHY 1907 5000 AGES 0 - 20
Page Number: 12CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 1
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST JEFFERSON
RIVER RIDGE JEFFERSON COMMUNITY HEALTH CARE
11312 JEFFERSON HWY RIVER RIDGE, LA 70123(504) 463-3002
FQHC 120 2500
Page Number: 13CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
EAST JEFFERSON GENERAL PRACTICE
2
FAMILY PRACTICE 3
OB/GYN 1
PEDIATRICS 2
INTERNAL 6
OTHER 29
FQHC 2
TOTAL: 45 227,251 41,168
JEFFERSON OTHER 15
FQHC 2
GENERAL PRACTICE
1
FAMILY PRACTICE 2
INTERNAL 2
PEDIATRICS 4
TOTAL: 26 111,000 44,663
ORLEANS INTERNAL 3
OTHER 49
GENERAL PRACTICE
4
FAMILY PRACTICE 3
PEDIATRICS 3
FQHC 5
TOTAL: 67 251,700 57,904
CommunityCARE Provider Summary Count By ParishREGION 1
Page Number: 14CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
PLAQUEMINES OTHER 2
TOTAL: 2 10,000 658
ST. BERNARD OTHER 5
TOTAL: 5 16,500 4,989
REGION TOTALS 145 616,451 149,382
Page Number: 15CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ASCENSION DONALDSONVILLE
FAMILY MEDICAL CLINIC 217 RAILROAD AVENUE DONALDSONVILLE, LA 70346(225) 473-3931
RHC RURAL HEALTH CLINIC
1043 2500 AGES 0 - 64
ST ELIZABETH PHYSICIANS 214 CLINIC DRIVE DONALDSONVILLE, LA 70346(225) 473-8151
PHY 569 7000 CURRENT PATIENTS AGES 0 - 64
GONZALES NOWAKOWKI BOGDAN 1433 EAST HWY 30 GONZALES, LA 70737(225) 647-6900
PHY PULMONARY DISEASES
250 2500 AGES 8 - 64
SOUTHERN MEDICAL ASSOCIATES 2524 S PHILIPPE AVE GONZALES, LA 70737(225) 644-1990
PHY CLINIC OR OTHER GROUP PRACTICE
1614 5000 AGES 0 - 64
ST ELIZABETH PHYSICIANS 2647 S ST ELIZABETH BLVD #316GONZALES, LA 70737(225) 647-8511
PHY 891 5500 CURRENT PATIENTS AGES 0 - 64
ST ELIZABETH PHYSICIANS 2647 S ST ELIZABETH BLVD #100GONZALES, LA 70737(225) 647-8511
PHY 1736 16500 CURRENT PATIENTS AGES 0 - 64
ST ELIZABETH PHYSICIANS 1702 N. BURNSIDE AVENUE, STE A GONZALES, LA 70737(225) 647-8319
PHY 374 2500 CURRENT PATIENTS AGES 0 - 64
ST ELIZABETH PHYSICIANS 721 EAST HWY 30 GONZALES, LA 70737(225) 644-7337
PHY 1208 2500 CURRENT PATIENTS AGES 0 - 14
TWUM-ANTWI YAW 723 EAST HIGHWAY 30 GONZALES, LA 70737(225) 644-5393
PHY INTERNAL MEDICINE 964 2500 AGES 6 - 64
VAZQUEZ-BORRERO CARLOS 1937 SOUTH BURNSIDE GONZALES, LA 70737(225) 647-1947
PHY INTERNAL MEDICINE 538 2500 AGES 12 - 64
WILLIAMS JERRY 317 W. ASCENSION GONZALES, LA 70737(225) 647-9297
PHY INTERNAL MEDICINE 240 2500 AGES 21 - 64
PRAIRIEVILLE
MAGNOLIA PEDIATRICS 17503 OLD JEFFERSON HWY PRAIRIEVILLE, LA 70769(225) 744-4484
PHY CLINIC OR OTHER GROUP PRACTICE
517 8000 AGES 0 - 15
Page Number: 16CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ASCENSION PRAIRIEVILLE
ST ELIZABETH PHYSICIANS 14225 HWY 73 PRAIRIEVILLE, LA 70769(225) 673-3033
PHY 734 7500 CURRENT PATIENTS AGES 0 - 64
ST ELIZABETH PHYSICIANS 17609 JEFFERSON HWY STE DPRAIRIEVILLE, LA 70769(225) 677-9595
PHY 506 18500 CURRENT PATIENTS AGES 1 - 64
EAST BATON ROUGE
BAKER DEJOHN MICHAEL 4444 GROOM ROAD BAKER, LA 70714(225) 774-9134
PHY 40 2500 CURRENT PATIENTS AGES 21 - 64
INTERNAL MEDICINE AND PEDIATRICS 6516 E MYRTLE ST BAKER, LA 70714(225) 774-7320
PHY CLINIC OR OTHER GROUP PRACTICE
2467 2500 LIMITED PANEL; AGES 0 - 16
MANALAC RODOLFO 3034 RAYWEILAND DRIVE BAKER, LA 70714(225) 775-8500
PHY FAMILY PRACTICE 26 2500 AGES 40 - 64
MOUTON MARK 12902 PLANK ROAD BAKER, LA 70714(225) 774-7111
PHY INTERNAL MEDICINE 300 2500 AGES 21 - 64
THOMPSON E.GENE 12902 PLANK ROAD BAKER, LA 70714(225) 774-3883
PHY INTERNAL MEDICINE 44 2500 CURRENT PATIENTS AGES 21 - 64
BATON ROUGE
ACADIAN MEDICAL CLINIC 412 NORTH ACADIAN THRUWAY BATON ROUGE, LA 70806(225) 338-1145
PHY CLINIC OR OTHER GROUP PRACTICE
527 2500 AGES 2 - 64
BANKS RAYNANDO 3905 CONVENTION STREET BATON ROUGE, LA 70806(225) 387-7858
PHY FAMILY PRACTICE 775 2500 AGES 5 - 64
BATON ROUGE PEDIATRIC CLINIC 7750 GREENWELL SPRINGS RD BATON ROUGE, LA 70814(225) 928-9550
PHY CLINIC OR OTHER GROUP PRACTICE
2271 3000 CURRENT PATIENTS AGES 0 - 20
BATON ROUGE PRIMARY CARE COLLEGE
7855 HOWELL BLVD, SUTIE 330 BATON ROUGE, LA 70807(225) 774-1120
FQHC 678 3500 AGES 0 - 64
BATON ROUGE PRIMARY CARE COLLEGE
220 ST. VINCENT DEPAUL PLACE BATON ROUGE, LA 70802(225) 343-9086
FQHC 140 1000 AGES 0 - 64
Page Number: 17CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST BATON ROUGE
BATON ROUGE
BOSTICK LESLIE 8595 PICARDY AVE STE 200BATON ROUGE, LA 70809(225) 767-5520
PHY PEDIATRICS 469 2500 CURRENT PATIENTS & NEWBORNS AGES 0 - 11
CAPITOL CITY FAMILY HEALTH CENTER 3140 FLORIDA BLVD BATON ROUGE, LA 70806(225) 650-2000
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
2615 6500 AGES 0 - 64
CHALASANI LALITHA 3401 NORTH BLVD STE 325BATON ROUGE, LA 70806(225) 381-2789
PHY INTERNAL MEDICINE 169 2500 AGES 21 - 64
CHEVALIER TIFFANNY 8786 GOODWOOD BLVD,STE 105 BATON ROUGE, LA 70806(225) 927-7480
PHY PEDIATRICS 1420 2500 OPEN AGES 0 - 1 MTH;CURRENT PTS AGES 2 MTHS -17YRS
CHILD HEALTH AMERICAN PHYSICIANS 3955 GOVERNMENT ST STE 1BATON ROUGE, LA 70806(225) 343-1565
PHY CLINIC OR OTHER GROUP PRACTICE
1568 2500 AGES 0 - 20
CURRY JANE 8235 YMCA PLAZA DR STE 100BATON ROUGE, LA 70810(225) 766-1109
PHY PEDIATRICS 338 2500 OPEN AGES BIRTH - 6 MNTHS;CURR PTS AGES 7M - 17YR
DAO XUONG 12389 FLORIDA BLVD. BATON ROUGE, LA 70815(225) 272-8222
PHY INTERNAL MEDICINE 776 2500 AGES 0 - 64
DESPINASSE-II BRIAN 730 COLONIAL DRIVE, SUITE B BATON ROUGE, LA 70815(225) 924-7343
PHY PEDIATRICS 1325 2500 OPEN AGES 0 - 4M; CURR PTS & SIBLINGS AGES 5M -20Y
DIAL DANIEL 10880 JOOR ROAD BATON ROUGE, LA 70818(225) 262-7710
PHY INTERNAL MEDICINE 18 2500 CURRENT PATIENTS AGES 21 - 64
FAMILY HEALTH CENTER 3801 NORTH BOULEVARD BATON ROUGE, LA 70806(225) 381-6620
PHY CLINIC OR OTHER GROUP PRACTICE
2357 3500 LIMITED PANEL; AGES 0 - 64
FELDMAN ROBERT 4245 WINBOURNE AVENUE BATON ROUGE, LA 70805(225) 357-2248
PHY PEDIATRICS 2204 2500 AGES 0 - 20
HALL COREY 606 COLONIAL DRIVE , SUITE A BATON ROUGE, LA 70806(225) 930-9045
PHY FAMILY PRACTICE 416 2500 AGES 21 - 64
Page Number: 18CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST BATON ROUGE
BATON ROUGE
HOWARD MICHAEL 3525 RILEY STREET BATON ROUGE, LA 70805(225) 356-2004
PHY GENERAL PRACTICE 579 2500 AGES 21 - 64
IBEKWE RUBY 3923 CONVENTION ST. BATON ROUGE, LA 70806(225) 381-6474
PHY FAMILY PRACTICE 741 2500 AGES 2 MONTHS - 64 YEARS
JAMES E HINES-III 2153 NORTH FOSTER DRIVE BATON ROUGE, LA 70806(225) 356-9775
PHY GENERAL PRACTICE 1013 2500 AGES 0 - 64
LPCP FAMILY PRACTICE ASSOCIATES 12525 PERKINS ROAD SUITE A BATON ROUGE, LA 70810(225) 765-4256
PHY 24 10000 CLOSED PANEL
LPCP INTERNAL MEDICINE OF BATON ROUGE
7777 HENNESSY BLVD SUITE 7000 BATON ROUGE, LA 70808(225) 765-8829
PHY 95 17500 CURRENT PATIENTS AGES 18 - 64
LPCP LAKE PEDIATRICS @ O'NEAL LANE
2380 O'NEAL LANE STE A BATON ROUGE, LA 70816(225) 214-3714
PHY 1875 5000 OPEN BIRTH - 2 MONTH; CURR PTS & SIBLINGS 2M - 15Y
LPCP NEIGHBORHOOD CLINIC 9422 SCOTLAND AVENUE BATON ROUGE, LA 70807(225) 774-1822
PHY 1328 1000 MAX CAPACITY EXCEEDED; AGES 0 - 64
LPCP PEDIATRIC ACADEMIC CLINIC 8415 GOODWOOD BLVD, SUITE 202 BATON ROUGE, LA 70806(225) 765-8013
PHY 1043 7500 AGES 0 - 18
LPCP PEDIATRIC MEDICAL CENTER 12525 PERKINS ROAD, SUITE C BATON ROUGE, LA 70810(225) 769-2003
PHY 2372 20000 OPEN AGES 0 - 3 MONTHS CURRENT PATIENTS & SIBLINGS
LPCP PEDS @ GOODWOOD (KIDMED) 8415 GOODWOOD BLVD. STE 100 BATON ROUGE, LA 70806(225) 765-5633
PHY 10683 11500 AGES 0 - 5; CURRENT PTS & SIBLINGS AGES 6 - 18
LPCP PRIMARY CARE OF SOUTH BATON ROUGE
18135 E. PETROLEUM DR. SUITE ABATON ROUGE, LA 70809(225) 765-5247
PHY 305 7500 OPEN NEW PTS 0 - 2M, CURR PTS & SIBLINGS 3M - 17Y
LPCP SENIOR CARE OF IM OF BR 5339 DIDESSE BATON ROUGE, LA 70808(225) 765-3076
PHY 4 5500 CLOSED PANEL
Page Number: 19CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST BATON ROUGE
BATON ROUGE
LPCP SOUTHEAST PEDIATRIC 8415 GOODWOOD BLVD. SUITE 104 BATON ROUGE, LA 70806(225) 925-9797
PHY 3813 10500 OPEN AGES 0 - 2; CURRENT PTS & SIBLINGS AGES 3 -20
LSUHN EKL-FAMILY 1401 NORTH FOSTER DRIVE BATON ROUGE, LA 70806(225) 987-9000
PHY 944 15000 AGES 18 - 64
LSUHN EKL-LEO BUTLER 950 EAST WASHINGTON BATON ROUGE, LA 70802(225) 358-2520
PHY 259 3000 AGES 18 - 64
LSUHN EKL-MEDICINE 5825 AIRLINE HWY BATON ROUGE, LA 70805(225) 358-1110
PHY 663 5000 AGES 18 - 64
LSUHN EKL-NORTH BATON ROUGE 5439 AIRLINE HIGHWAY BATON ROUGE, LA 70805(225) 358-2280
PHY 344 3000 AGES 18 - 64
LSUHN EKL-PEDIATRICS 1401 NORTH FOSTER DR BATON ROUGE, LA 70806(225) 987-9000
PHY 4154 12500 AGES 0 - 18
MAYO TAMIKA 3401 NORTH BLVD STE 360BATON ROUGE, LA 70806(225) 381-2712
PHY FAMILY PRACTICE 1106 2500 AGES 1 - 64
MAYS STAN J. 4242 GUS YOUNG AVENUE BATON ROUGE, LA 70802(225) 926-2258
PHY FAMILY PRACTICE 816 2500 AGES 0 - 64
MURRILL MELVIN 4560 NORTH BLVD STE 108BATON ROUGE, LA 70806(225) 928-0695
PHY PEDIATRICS 2140 2500 AGES 0 - 20
OLD HAMMOND PEDIATRICS 11548 OLD HAMMOND HWY BATON ROUGE, LA 70815(225) 273-5995
PHY CLINIC OR OTHER GROUP PRACTICE
2787 3500 OPEN AGES 0 - 12; CURR PTS & SIBLINGS AGES 13 - 18
OPTIMAL HEALTH OUT-PATIENT CLINIC 7240 RENOIR AVE BATON ROUGE, LA 70806(225) 932-9150
PHY 702 2500 AGES 0 - 64
PEDIATRIC HEALTH ASSOCIATES 624 CHEVELLE CT BATON ROUGE, LA 70806(225) 925-2055
PHY CLINIC OR OTHER GROUP PRACTICE
1521 2500 AGES 0 - 18
Page Number: 20CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST BATON ROUGE
BATON ROUGE
PEDICONS INC DBA KIDMED NORTH 5151 PLANK RD BATON ROUGE, LA 70805(225) 356-2006
PHY 3503 3500 AGES 0 - 20
PEDICONS INC DBA KIDMED SOUTH 7612 PICARDY AVE STE CBATON ROUGE, LA 70808(225) 767-3800
PHY 2621 3000 AGES 0 - 20
PHAM LUAN 9936 FLORIDA BLVD, STE B BATON ROUGE, LA 70815(225) 927-8772
PHY FAMILY PRACTICE 898 2500 NEW PTS AGES 0 - 20; CURRENT PTS AGES 21 - 64
ROBERTS JONATHAN 8333 GOODWOOD BLVD BATON ROUGE, LA 70806(225) 952-9460
PHY INTERNAL MEDICINE 364 2500 AGES 21 - 64
RONALD ANDREWS MD 8894 AIRLINE HWY STE QBATON ROUGE, LA 70815(225) 922-8377
PHY CLINIC OR OTHER GROUP PRACTICE
427 2500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 64
SEFA AKWASI 4560 NORTH BLVD. SUITE 101 BATON ROUGE, LA 70806(225) 925-2331
PHY INTERNAL MEDICINE 707 1000 LIMITED PANEL; AGES 14 - 64
SMITH CHRISTINE 11281 OLD HAMMOND HWY BLDG BBATON ROUGE, LA 70815(225) 275-4656
PHY FAMILY PRACTICE 148 2500 CLOSED PANEL
STANOCOLA MEDICAL CENTER - I.M. 16777 MEDICAL CENTER, STE. 400 BATON ROUGE, LA 70816(225) 926-7200
PHY 189 2500 LIMITED PANEL; AGES 21 - 64
STANOCOLA MEDICAL CENTER - P.C. 16777 MEDICAL CTR DR STE 400BATON ROUGE, LA 70816(225) 926-7200
PHY 237 8000 LIMITED PANEL; AGES 21 - 64
STANOCOLA MEDICAL CLINIC 16777 MEDICAL CTR DR.,STE.400 BATON ROUGE, LA 70816(225) 952-8540
PHY 1105 2500 AGES 0 - 20
THE PRIMARY CARE GROUP - MIDCITY 3401 NORTH BLVD,STE 130 BATON ROUGE, LA 70806(225) 381-2727
PHY CLINIC OR OTHER GROUP PRACTICE
805 10000 AGES 0 - 64
THOMAS VERONICA 8786 GOODWOOD BLVD SUITE 107BATON ROUGE, LA 70806(225) 810-4785
PHY PEDIATRICS 1096 2500 NEWBORNS AGES 0 - 3M; CURR PTS& SIBLINGS 4M - 15Y
Page Number: 21CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST BATON ROUGE
BATON ROUGE
URGENT CARE & FAMILY MEDICINE 1962 ONEAL LN STE H1BATON ROUGE, LA 70816(225) 755-0095
PHY CLINIC OR OTHER GROUP PRACTICE
1214 2500
WILLIAMS JACQUELINE 7516 PICARDY AVE STE BBATON ROUGE, LA 70808(225) 765-7144
PHY PEDIATRICS 946 2500 CURRENT PATIENTS AGES 0 - 15
ZACHARY KHELGHATI AMRULLAH 9305 MAIN STREET STE DZACHARY, LA 70791(225) 654-0300
PHY PEDIATRICS 1750 2500 AGES 0 - 20
LPCP PRIMARY CARE OF ZACHARY 18989 OLD SCENIC HWY ZACHARY, LA 70791(225) 654-6140
PHY 424 2500 OPEN AGES 0 - 2 MONTHS & SIBLINGS OF EXISTING PTS
MEDINA JUAN 4727 WEST PARK DR STE AZACHARY, LA 70791(225) 658-8111
PHY INTERNAL MEDICINE 31 2500 CURRENT PATIENTS AGES 16 - 64
MONROE-WILKES GRETA 6110 MAIN STREET ZACHARY, LA 70791(225) 658-2036
PHY FAMILY PRACTICE 457 2500 AGES 0 - 64
SANTOS-MATA ELENITA 4851 WEST PARK DR STE AZACHARY, LA 70791(225) 658-7636
PHY PEDIATRICS 405 2500 CURRENT PATIENTS, NEWBORNS & SIBLINGS AGES 0 - 16
ZACHARY FAMILY PRACTICE 2335 CHURCH STREET, STE. E ZACHARY, LA 70791(225) 654-3607
PHY CLINIC OR OTHER GROUP PRACTICE
69 10000 CLOSED PANEL
EAST FELICIANA
CLINTON CLINTON HIGH HEALTH CENTER 10410 PLANK RD CLINTON, LA 70722(225) 683-1340
FQHC RHC/FQHC OPH CERTIFIED SBHC
10 1000 AGES 0 - 64
CLINTON LOWER HEALTH CENTER 10701 REILEY ST CLINTON, LA 70722(225) 683-1350
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
11 1000 AGES 0 - 64
CLINTON MIDDLE HEALTH CENTER 12126 LIBERTY CLINTON, LA 70722(225) 683-8877
FQHC RHC/FQHC OPH CERTIFIED SBHC
31 3000 AGES 0 - 64
DEJOHN MICHAEL 11315 LIBERTY HIGHWAY CLINTON, LA 70722(225) 683-3358
PHY 43 2500 CURRENT PATIENTS AGES 12 - 64
Page Number: 22CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EAST FELICIANA
CLINTON KAKARALA VENU 11333 CHURCH STREET CLINTON, LA 70722(225) 683-3901
PHY INTERNAL MEDICINE 112 2500 AGES 0 - 64
RATHBONE CLINIC 11323 CHURCH STREET CLINTON, LA 70722(225) 683-3377
PHY CLINIC OR OTHER GROUP PRACTICE
393 3000 AGES 0 - 64
RKM PRIMARY CARE 11990 JACKSON ST CLINTON, LA 70722(225) 683-5292
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1105 3500 AGES 0 - 64
JACKSON JACKSON COMPLEX HEALTH CENTER 3501 HWY 10 JACKSON, LA 70748(225) 683-1360
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
5 1000 AGES 0 - 64
NWABUEZE NNAMDI 3050 CHARLES DRIVE JACKSON, LA 70748(225) 634-3517
PHY GENERAL PRACTICE 776 2500 AGES 0 - 64
SLAUGHTER SLAUGHTER HEALTH CENTER 3170 CHURCH ST SLAUGHTER, LA 70777(225) 683-1370
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
34 1000 AGES 0 - 64
IBERVILLE GROSSE TETE
HEALTH CARE FIRST MEDICAL CLINIC 18015 WILLOW STREET GROSSE TETE, LA 70740(225) 648-3433
RHC RURAL HEALTH CLINIC
119 1000 AGES 0 - 64
MARINGOUIN MARINGOUIN MEDICAL CENTER 77695 WAGLEY ROAD MARINGOUIN, LA 70757(225) 625-2313
PHY CLINIC OR OTHER GROUP PRACTICE
225 500 AGES 0 - 64
PLAQUEMINE BROWN ANDREA 23845 CHURCH STREET PLAQUEMINE, LA 70764(225) 687-2828
PHY FAMILY PRACTICE 455 2500 AGES 0 - 35
FAMILY FIRST MEDICAL CLINIC 25073 HWY 1 SOUTH PLAQUEMINE, LA 70764(225) 687-1772
PHY CLINIC OR OTHER GROUP PRACTICE
88 2500 CURRENT PATIENTS AGES 0 - 64
FITCH ANDRIETTE 58155 CHINN STREET, STE B PLAQUEMINE, LA 70764(225) 687-8838
PHY INTERNAL MEDICINE 1145 2500 AGES 0 - 64
GARRISON-NORTH NEFRETITI 58155 CHINN STREET, SUITE B PLAQUEMINE, LA 70764(225) 687-8838
PHY PEDIATRICS 251 2500 AGES 0 - 64
Page Number: 23CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
IBERVILLE PLAQUEMINE PEDIATRIC ASSOCIATES 59325 RIVERWEST DR., SUITE D PLAQUEMINE, LA 70764(225) 687-3055
PHY CLINIC OR OTHER GROUP PRACTICE
5523 5000 MAX CAPACITY EXCEEDED; AGES 0 - 18
PRIME HEALTH LLC 59295 RIVERWEST DR STE CPLAQUEMINE, LA 70764(225) 687-2001
RHC RURAL HEALTH CLINIC
583 6000 AGES 0 - 64
REDDY FAMILY MEDICAL CL - PLAQ 58725 BELLEVIEW RD STE A-5PLAQUEMINE, LA 70764(225) 687-6200
RHC RURAL HEALTH CLINIC
273 1000 AGES 0 - 64
ST. GABRIEL ST. GABRIEL HEALTH CLINIC INC 5760 MONTICELLO ST ST. GABRIEL, LA 70776(225) 642-9676
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
228 1000 AGES 0 - 64
WHITE CASTLE
REDDY FAMILY MEDICAL CLINIC OF WHITE CASTLE
32985 BOWIE STREET WHITE CASTLE, LA 70788(225) 545-3631
RHC RURAL HEALTH CLINIC
238 1000 AGES 0 - 64
POINTE COUPEE
INNIS INNIS COMMUNITY HEALTH CENTER 6450 LA HWY 1 INNIS, LA 70747(225) 492-3775
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
447 2500 AGES 0 - 64
LIVONIA LIVONIA COMMUNITY HEALTH CENTER 3041 FORDOCHE RD. LIVONIA, LA 70755(225) 637-3535
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
395 5000 AGES 0 - 64
NEW ROADS BRIAN LEBLANC MD 160 HOSPITAL ROAD NEW ROADS, LA 70760(225) 638-4686
RHC RURAL HEALTH CLINIC
855 2500 NEW PTS AGES 0 - 17; CURRENT PATIENTS AGES 18 - 64
CARL MCLEMORE MD 230 ROBERTS DR STE BNEW ROADS, LA 70760(225) 638-8661
RHC RURAL HEALTH CLINIC
688 2500 NEW PTS AGES 0 - 17; CURRENT PATIENTS AGES 18 - 64
DONALD DOUCET MD & ASSOCIATES 230 ROBERTS DRIVE STE 1NEW ROADS, LA 70760(225) 638-4585
PHY CLINIC OR OTHER GROUP PRACTICE
16 5000 CURRENT PATIENTS ONLY AGES 19 - 64
LOUIS V MONTE LARO MD 230 ROBERTS DR STE ENEW ROADS, LA 70760(225) 638-3781
RHC RURAL HEALTH CLINIC
323 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 17
LPCP DR. CAROL SMOTHERS 230 ROBERTS DR STE DNEW ROADS, LA 70760(225) 638-8911
PHY 633 2500 AGES 0 - 64
Page Number: 24CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 2
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
POINTE COUPEE
NEW ROADS PAUL RACHAL MD 230 ROBERTS DR STE HNEW ROADS, LA 70760(225) 638-7033
RHC RURAL HEALTH CLINIC
466 2500 NEWBORNS & SIBLINGS OF CURRENT PTS AGES 0 - 17
WEST BATON ROUGE
BRUSLY WESTSIDE FAMILY MEDICINE 402 N VAUGHN ST BRUSLY, LA 70719(225) 749-2645
PHY CLINIC OR OTHER GROUP PRACTICE
698 5000 AGES 0 - 64
PORT ALLEN LPCP ASSOCIATES IN INTERNAL MEDICINE
4463 LA HWY 1 SOUTH PORT ALLEN, LA 70767(225) 687-9700
PHY 332 2500 CURRENT PATIENTS AGES 0 - 64
REDDY SANTHOSH 970 N ALEXANDER PORT ALLEN, LA 70767(225) 383-6363
PHY INTERNAL MEDICINE 823 2500 AGES 0 - 64
WBR PRIMARY CARE 751 COURT ST PORT ALLEN, LA 70767(225) 389-1311
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
331 3000 AGES 0 - 64
WEST FELICIANA
CLINTON OPTIMAL HEALTH OUT-PATIENT CLINIC 9508 HIGHWAY 67 STE BCLINTON, LA 70722(225) 683-4264
PHY 14 3000 AGES 0 - 64
ST FRANCISVILLE
SCHNEIDER PATRICIA 10273 GOULD DRIVE ST FRANCISVILLE, LA 70775(225) 635-9065
PHY PEDIATRICS 771 2500 AGES 0 - 22
ST. FRANCISVILLE
DANIEL SERVICES LLC 5326 OAK STREET ST. FRANCISVILLE, LA 70775(225) 635-5848
PHY CLINIC OR OTHER GROUP PRACTICE
950 8000 AGES 0 - 64; ONLY PTS IN EAST & WEST FELICIANA PAR
SCHNEIDER LAWRENCE 10289 GOULD DR STE CST. FRANCISVILLE, LA 70775(225) 635-3269
PHY FAMILY PRACTICE 368 2500 AGES 0 - 64
Page Number: 25CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
ASCENSION INTERNAL 3
RHC 1
OTHER 10
TOTAL: 14 85,500 11,184
EAST BATON ROUGE
OTHER 36
FAMILY PRACTICE 9
INTERNAL 8
GENERAL PRACTICE
2
PEDIATRICS 10
FQHC 1
TOTAL: 66 288,500 77,650
EAST FELICIANA OTHER 4
GENERAL PRACTICE
1
INTERNAL 1
FQHC 4
TOTAL: 10 21,000 2,520
IBERVILLE OTHER 3
INTERNAL 1
FQHC 1
FAMILY PRACTICE 1
PEDIATRICS 1
RHC 4
TOTAL: 11 25,500 9,128
CommunityCARE Provider Summary Count By ParishREGION 2
Page Number: 26CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
POINTE COUPEE OTHER 2
FQHC 2
RHC 4
TOTAL: 8 25,000 3,823
WEST BATON ROUGE
FQHC 1
OTHER 2
INTERNAL 1
TOTAL: 4 13,000 2,184
WEST FELICIANA OTHER 2
FAMILY PRACTICE 1
PEDIATRICS 1
TOTAL: 4 16,000 2,103
REGION TOTALS 117 474,500 108,592
Page Number: 27CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 3
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ASSUMPTION NAPOLEONVILLE
ASSUMPTION COMMUNITY HOSPITAL 143 HWY 402 STE 4NAPOLEONVILLE, LA 70390(985) 369-1083
RHC RURAL HEALTH CLINIC
840 1000 AGES 0 - 64
REDDY FAMILY MEDICAL CLINIC OF NAPOLEONVILLE
154 HWY 1008 NAPOLEONVILLE, LA 70390(985) 369-1880
RHC RURAL HEALTH CLINIC
599 1000 AGES 0 - 64
PIERRE PART
FAMILY MEDICAL CLINIC 3407 HIGHWAY 70 PIERRE PART, LA 70339(985) 252-1000
RHC RURAL HEALTH CLINIC
305 1000 AGES 0 - 64
TECHE ACTION CLINIC @ PIERRE PART 3617 HWY 70 SOUTH PIERRE PART, LA 70339(985) 252-6211
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
277 2500
LAFOURCHE CUT OFF LADY OF THE SEA MEDICAL CLINIC 102 WEST 112TH ST CUT OFF, LA 70345(985) 632-6233
RHC RURAL HEALTH CLINIC
1886 4000 AGES 0 - 64
SMITH EDDIE 103 PICCOLA PARKWAY CUT OFF, LA 70345(985) 325-6226
PHY FAMILY PRACTICE 131 2500 CLOSED PANEL
GOLDEN MEADOW
LADY OF THE SEA GOLDEN MEADOW 176 WASHINGTON ST GOLDEN MEADOW, LA 70357(985) 475-5200
RHC RURAL HEALTH CLINIC
828 4000 AGES 0 - 64
LAROSE LADY OF THE SEA MEDICAL CLINIC - LAROSE
13030 HWY 308 LAROSE, LA 70373(985) 798-7000
RHC RURAL HEALTH CLINIC
1195 3500 AGES 0 - 64
RACELAND CHILDRENS CLINIC OF RACELAND 110 ACADIA DRIVE RACELAND, LA 70394(985) 537-8687
PHY 507 3000
OCHSNER ST ANNE FAMILY D 111 ACADIA PARK DRIVE RACELAND, LA 70394(985) 537-7575
PHY 692 8000
OCHSNER/ST ANNE INTERNAL MEDICINE CLINIC
4608 HIGHWAY 1 RACELAND, LA 70394(985) 537-2273
PHY 44 5000 AGES 21 - 64
RANDOLPH ROZALYNDE 4803 HWY 1 RACELAND, LA 70394(985) 532-1008
PHY PEDIATRICS 504 2500 AGES 0 - 20
Page Number: 28CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 3
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LAFOURCHE THIBODAUX CHILDREN'S CLINIC OF THIBODAUX 807 RIDGEFIELD ROAD THIBODAUX, LA 70301(985) 447-9045
PHY CLINIC OR OTHER GROUP PRACTICE
130 2500 CLOSED PANEL
SAYES R. MARK 206 EAST 2ND STREET THIBODAUX, LA 70301(985) 447-2629
PHY GENERAL PRACTICE 883 2500 AGES 10 - 20
THE CENTER FOR PEDIACTRIC & ADOLESCENT MEDICINE
604 N ACADIA RD STE 200THIBODAUX, LA 70301(985) 448-3700
PHY CLINIC OR OTHER GROUP PRACTICE
2775 5500 OPEN AGES 0 - 6M; 7M - 14Y CURR PTS; BLOCKED 15-17
THIBODAUX MEDICAL CLINIC 1214 CARDINAL DR THIBODAUX, LA 70301(985) 446-6381
PHY CLINIC OR OTHER GROUP PRACTICE
1784 3000 AGES 6 - 64
ST. CHARLES DESTREHAN CHILDRENS CLINIC LLC 3 STOREHOUSE LANE STE BDESTREHAN, LA 70047(985) 764-6556
PHY 1892 5000 AGES 0 - 18
LULING ST.CHARLES COMMUNITY HEALTH CLINIC
843 MILLING AVENUE LULING, LA 70070(985) 785-5800
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
3534 12500 AGES 0 - 64
VIAL-BENSON MONICA 126 POST DRIVE LULING, LA 70070(985) 785-6204
PHY PHYSICAL MEDICINE REHABILITATION
329 2500 AGES 13 - 64
NORCO ST CHARLES COMMUNITY HEALTH CENTER
941 FIRST STREET NORCO, LA 70079(985) 725-9330
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
237 2500 AGES 0 - 64
ST. JAMES GRAMERCY ST. JAMES PRIMARY CARE 827 N. PINE STREET GRAMERCY, LA 70052(225) 869-9200
RHC RURAL HEALTH CLINIC
1571 2500 AGES 0 - 64
VACHERIE S K DONEPUDI MD APMC 21420 HWY 20 W VACHERIE, LA 70090(225) 265-3013
PHY CLINIC OR OTHER GROUP PRACTICE
202 3000 AGES 6 - 64
ST JOSEPH MEDICAL CLINIC 22080 LA HWY 20 WEST VACHERIE, LA 70090(225) 265-3061
RHC RURAL HEALTH CLINIC
689 5500 AGES 0 - 64
ST PHILIP CLINIC 1108 ST JAMES STREET VACHERIE, LA 70090(225) 265-4087
PHY CLINIC OR OTHER GROUP PRACTICE
594 2500 CURRENT PATIENTS AGES 0 - 64
Page Number: 29CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 3
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. JOHN EDGARD TECHE ACTIONC CLINIC-EDGARD PC 159 EAST 3RD STREET EDGARD, LA 70049(985) 497-8726
FQHC 70 1000 AGES 0 - 64
LAPLACE AVOTRI KOSI 1819 W. AIRLINE HWY SUITE 10LAPLACE, LA 70068(985) 651-5751
PHY PEDIATRICS 711 2500 AGES 0 - 20
CHILDREN'S HOSPITAL MEDICAL PRACTICE CORPORATION
501 RUE DE SANTE, STE 13 LAPLACE, LA 70068(985) 652-6359
PHY 723 2500 NEW PTS AGES BIRTH - 1 YR; CURRENT PTS AGES 2 - 20
PEDIATRIC MEDICAL CLINIC 501 RUE DE SANTE STE 9LAPLACE, LA 70068(985) 651-7444
PHY 1026 2500 AGES 0 - 20
RAINBOW PEDIATRICS 451 RUE DE SANTE LAPLACE, LA 70068(985) 652-4400
PHY CLINIC OR OTHER GROUP PRACTICE
1112 7500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 18
ST JAMES PRIMARY CARE 502 RUE DE SANTE STE 301LAPLACE, LA 70068(985) 652-5475
RHC RURAL HEALTH CLINIC
1644 3000 AGES 0 - 64
RESERVE FAMILY MEDICINE CENTER OF RESERVE
147 CENTRAL AVE RESERVE, LA 70084(985) 536-2605
RHC RURAL HEALTH CLINIC
1191 3000 AGES 0 - 64
ST. MARY BALDWIN FRANKLIN FOUNDATION HOSPITAL 100 LIVE OAK STREET BALDWIN, LA 70514(337) 923-7040
PHY CLINIC OR OTHER GROUP PRACTICE
90 500 AGES 0 - 64
FRANKLIN ACADIANA FAMILY PRACTICE 1501 BETHIA STREET FRANKLIN, LA 70538(337) 828-3507
RHC RURAL HEALTH CLINIC
749 5000 AGES 0 - 64
CHUA JESUS 602 HAIFLEIGH STREET FRANKLIN, LA 70538(337) 828-4037
PHY FAMILY PRACTICE 244 2500 AGES 0 - 64
GUNDA SHARAD 606 HAIFLEIGH STREET FRANKLIN, LA 70538(337) 828-4440
PHY PEDIATRICS 1715 2500 AGES 0 - 15
MCCORMICK LOUIS 606 HAIFLEIGH FRANKLIN, LA 70538(337) 828-4440
PHY FAMILY PRACTICE 664 2500 AGES 0 - 64
Page Number: 30CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 3
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. MARY FRANKLIN TECHE ACTION CLINIC 1115 WEBER STREET FRANKLIN, LA 70538(337) 828-2550
FQHC 827 7000 AGES 0 - 64
WELCH-SPENCER KEIDRA 1420 NORTHWEST BLVD STE 4FRANKLIN, LA 70538(337) 828-3090
PHY FAMILY PRACTICE 206 2500 CURRENT PTS, DEPENDANTS & SIBLINGS AGES 6 - 64
MORGAN CITY
ALBERT LIANTER 1151 MARGUERITE ST STE 600MORGAN CITY, LA 70380(985) 384-3160
PHY INTERNAL MEDICINE 166 2500 CURRENT PATIENTS AGES 21 - 64
BASS SHARON 1300 LAKEWOOD DR., SUITE G MORGAN CITY, LA 70380(985) 385-2710
PHY FAMILY PRACTICE 408 2500 AGES 0 - 18
BLEREAU ROBERT 1122 EIGHTH STREET MORGAN CITY, LA 70380(985) 385-3000
PHY FAMILY PRACTICE 565 2500 CURRENT PTS AGES 2 - 64; ACCEPTS PTS BIRTH - 1
THE PEDIATRIC CLINIC OF ST MARY 1234 DAVID DR,STE A MORGAN CITY, LA 70380(985) 384-2430
PHY CLINIC OR OTHER GROUP PRACTICE
4553 8500 AGES 0 - 20
TERREBONNE HOUMA ARUNAVATHI SANGISETTY MD 1281 W TUNNEL BLVD HOUMA, LA 70360(985) 876-2321
PHY CLINIC OR OTHER GROUP PRACTICE
6080 10500 AGES 0 - 20
AUDUBON PEDIATRICS LLC 216 MYSTIC BLVD STE BHOUMA, LA 70360(985) 868-9339
PHY CLINIC OR OTHER GROUP PRACTICE
917 5000 OPEN AGES 0 - 3MONTHS; BLOCKED AGES 4MNTHS - 18 YR
BAYOU PEDIATRIC ASSOCIATES 8120 MAIN STREET, SUITE 300 HOUMA, LA 70360(985) 872-6405
PHY CLINIC OR OTHER GROUP PRACTICE
4760 13000 AGES 0 - 20; ACCEPTS AGES 0 - 15 ONLY
DAVULURI CHILDRENS CLINIC 1020 LEE AVE HOUMA, LA 70360(985) 868-7500
PHY CLINIC OR OTHER GROUP PRACTICE
1945 2500 AGES 0 - 21
FADI ABOU-ISSA MD 8120 MAIN STREET, SUITE 301 HOUMA, LA 70360(985) 851-6653
PHY 46 2500 CLOSED PANEL
HOUMA HEALTH CLINIC LLC 827 BAYOU GARDENS BLVD HOUMA, LA 70364(985) 853-2343
PHY CLINIC OR OTHER GROUP PRACTICE
709 3000 AGES 21 - 64
Page Number: 31CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 3
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
TERREBONNE HOUMA INTERNAL MEDICINE ASSOCIATES OF HOUMA
855 BELANGER ST STE 102HOUMA, LA 70360(985) 873-2961
PHY CLINIC OR OTHER GROUP PRACTICE
23 6000 AGES 21 - 64 ONLY RESIDENTS OF TARC
INTERNAL MEDICINE CLINIC OF HOUMA 911 VERRET STREET HOUMA, LA 70360(985) 876-7388
PHY CLINIC OR OTHER GROUP PRACTICE
36 3500 CLOSED PANEL
SANUSI ABAYOMI 325 LIBERTY STREET HOUMA, LA 70360(985) 879-3600
PHY INTERNAL MEDICINE, DIAGNOSTIC LABORATORY IMMUNOLOGY
423 2500 AGES 21 - 64
SOUTH LOUISIANA MEDICAL ASSOCIATION
1990 INDUSTRIAL BLVD. HOUMA, LA 70363(985) 873-1730
PHY CLINIC OR OTHER GROUP PRACTICE
5467 58500 AGES 0 - 64
SUGARLAND PEDIATRICS LLC 5642 W MAIN ST HOUMA, LA 70360(985) 853-2273
PHY CLINIC OR OTHER GROUP PRACTICE
749 2500 AGES 0 - 12 MONTHS
TECHE ACTION CLINIC @ HOUMA 809 WEST TUNNEL BLVD HOUMA, LA 70360(985) 851-1717
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
637 3000 AGES 0 - 64
TECHE ACTION CLINIC-DULAC 189 MOZART DRIVE HOUMA, LA 70360(985) 868-3700
FQHC 844 1000 AGES 0 - 64
WOMENS OB/GYN HEALTH & WELLNESS
1022 BELANGER STREET HOUMA, LA 70360(985) 868-1561
PHY 159 7000
Page Number: 32CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
ASSUMPTION RHC 3
FQHC 1
TOTAL: 4 5,500 2,021
LAFOURCHE OTHER 6
GENERAL PRACTICE
1
RHC 3
FAMILY PRACTICE 1
PEDIATRICS 1
TOTAL: 12 46,000 11,359
ST. CHARLES FQHC 2
OTHER 2
TOTAL: 4 22,500 5,992
ST. JAMES RHC 2
OTHER 2
TOTAL: 4 13,500 3,056
ST. JOHN PEDIATRICS 1
OTHER 4
RHC 2
TOTAL: 7 22,000 6,477
ST. MARY PEDIATRICS 1
INTERNAL 1
RHC 1
OTHER 3
FAMILY PRACTICE 5
CommunityCARE Provider Summary Count By ParishREGION 3
Page Number: 33CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
ST. MARY TOTAL: 11 38,500 10,187
TERREBONNE OTHER 12
INTERNAL 1
FQHC 1
TOTAL: 14 120,500 22,795
REGION TOTALS 56 268,500 61,887
Page Number: 34CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ACADIA CHURCH POINT
FELTON MICHAEL 814 SOUTH BROADWAY CHURCH POINT, LA 70525(337) 684-3178
PHY FAMILY PRACTICE 369 650 LIMITED PANEL; AGES 0 - 64
POLANCO MARCELO 731 SOUTH MAIN ST SUITE ACHURCH POINT, LA 70525(337) 684-0911
PHY FAMILY PRACTICE 688 2500 AGES 0 - 64
CROWLEY ACADIA FAMILY CLINIC LLC 703 E 8TH STREET CROWLEY, LA 70526(337) 788-1081
RHC RURAL HEALTH CLINIC
319 1000 AGES 0 - 64
BRILEY-WALKER NANCY 1307 CROWLEY RAYNE HWY STE CCROWLEY, LA 70526(337) 788-3032
PHY FAMILY PRACTICE 119 130 LIMITED PANEL; AGES 21 - 64
CANNON STEPHEN 719 NORTH EASTERN AVE CROWLEY, LA 70526(337) 783-5900
PHY FAMILY PRACTICE 236 2500 CURRENT PATIENTS AGES 0 - 64
CROWLEY WALK-IN CLINIC 621 N. AVE K CROWLEY, LA 70526(337) 783-8215
PHY CLINIC OR OTHER GROUP PRACTICE
2933 5500 AGES 0 - 64
DELAHOUSSAYE BENTON 1307 CROWLEY RAYNE HWY,STE A CROWLEY, LA 70526(337) 783-3861
PHY MATERNAL & FETAL MEDICINE, OB/GYN
17 500 LIMITED PANEL;CURRENT PTS FEMALE ONLY AGES 21 - 64
ELFERT JR JOSEPH 1325 WRIGHT AVE,TOWER 1,STE F CROWLEY, LA 70526(337) 783-2915
PHY PEDIATRICS 1987 2500 AGES 0 - 18
HOLDEN JOE 421 NORTH AVENUE F CROWLEY, LA 70526(337) 788-0832
PHY GENERAL PRACTICE 527 2500 AGES 12 - 64
KATIRA MULRAJ 1455 WRIGHT AVE CROWLEY, LA 70526(337) 788-1733
PHY INTERNAL MEDICINE 5 2500 CLOSED PANEL
KRISHEN SWEETIE 1307 CROWLEY RAYNE HWY.,STE B CROWLEY, LA 70526(337) 783-6857
PHY PEDIATRICS 1444 2500 AGES 0 - 18; ACCEPTING NEW PTS AGES 0 - 14 ONLY
MELANSON MICHAEL 1307 CROWLEY RAYNE HWY,STE A CROWLEY, LA 70526(337) 783-3861
PHY MATERNAL & FETAL MEDICINE, OB/GYN
46 500 LIMITED PANEL;CURRENT PTS FEMALE ONLY AGES 21 - 64
Page Number: 35CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ACADIA CROWLEY SAINI SATINDER 1455 WRIGHT AVENUE CROWLEY, LA 70526(337) 788-1733
PHY INTERNAL MEDICINE 255 2500 AGES 21 - 64
SWLA CENTER FOR HEALTH S 613 JOHN F. KENNEDY DRIVE CROWLEY, LA 70526(337) 783-5519
FQHC 30 2500
THE FAMILY CLINIC OF CROWLEY 345 ODDFELLOWS ROAD CROWLEY, LA 70526(337) 783-7004
PHY CLINIC OR OTHER GROUP PRACTICE
210 5500 CURRENT PATIENTS AGES 0 - 64
RAYNE ACADIANA FAMILY MEDICAL ASSOCIATION
717 CURTIS DRIVE RAYNE, LA 70578(337) 334-7551
PHY CLINIC OR OTHER GROUP PRACTICE
1268 7500 CURRENT PATIENTS AGES 0 - 64
EVANGELINE BASILE DESHOTEL BOBBY 1431 FUSILIER BASILE, LA 70515(337) 432-6637
PHY GENERAL PRACTICE 224 2500 AGES 0 - 64
MAMOU ARDOIN BRENT 728 POINCIANA AVE MAMOU, LA 70554(337) 468-0267
PHY INTERNAL MEDICINE 95 2500 CURRENT PATIENTS AGES 6 - 64
BAKARE MEENA 1008 SIXTH ST. MAMOU, LA 70554(337) 468-2515
PHY PEDIATRICS 801 2500 AGES 0 - 20
FONTENOT JOHN 1415 7TH STREET, SUITE J MAMOU, LA 70554(337) 468-5150
PHY INTERNAL MEDICINE 70 2500 CURRENT PATIENTS ONLY AGES 21 - 64
RODRIGUEZ OSCAR 1413 SEVENTH ST, STE B MAMOU, LA 70554(337) 468-3310
PHY INTERNAL MEDICINE 161 2500 AGES 21 - 64
SAVOY GREGORY 1508 CAJUN DRIVE, SUITE B MAMOU, LA 70554(337) 468-5309
PHY GENERAL SURGERY 29 2500 CURRENT PATIENTS AGES 0 - 64
WOMENS MEDICAL & SURGICAL CLINIC 805 CHERRY STREET MAMOU, LA 70586(337) 468-2250
PHY CLINIC OR OTHER GROUP PRACTICE
131 3000 FEMALES ONLY, AGES 10 - 64
VILLE PLATTE
ALTAMIRANO DODANIM 504 JACK MILLER ROAD,SUITE 3 VILLE PLATTE, LA 70586(337) 363-3560
PHY PEDIATRICS 1672 2500 AGES 0 - 20
Page Number: 36CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
EVANGELINE VILLE PLATTE
ASWELL-III CHARLES 503 JACK MILLER RD STE AVILLE PLATTE, LA 70586(337) 363-7474
PHY INTERNAL MEDICINE 76 2500 CURRENT PATIENTS AGES 21 - 64
DUPRE HENRY 1008 WEST MAIN STREET VILLE PLATTE, LA 70586(337) 363-5531
PHY GENERAL PRACTICE 312 2500 AGES 18 MTHS-18 YRS; CURRENT PATIENTS AGE 19 - 64
FONTENOT CHARLES 1535 W. MAIN ST.,STE.6 VILLE PLATTE, LA 70586(337) 363-5521
PHY GENERAL PRACTICE 410 2500 AGES 1 - 64
FONTENOT THOMAS 417 E LINCOLN RD VILLE PLATTE, LA 70586(337) 363-7744
PHY GENERAL PRACTICE 266 2500 CURRENT PATIENTS AGES 0 - 64
HARRIS GEHRIG 1013 WEST LINCOLN ROAD VILLE PLATTE, LA 70586(337) 363-3330
PHY FAMILY PRACTICE 220 2500 AGES 0 - 64
LAFLEUR JEFFERY 503 JACK MILLER ROAD, SUITE B VILLE PLATTE, LA 70586(337) 363-7036
PHY INTERNAL MEDICINE 55 2500
RAINEY JOHN 504 JACK MILLER RD., SUITE 5 VILLE PLATTE, LA 70586(337) 363-2249
PHY FAMILY PRACTICE 29 2500
SOILEAU THOMAS 504 JACK MILLER RD STE 4VILLE PLATTE, LA 70586(337) 363-6480
PHY GENERAL PRACTICE 93 2500 CURRENT PATIENTS AGES 0 - 64
TASSIN A J 1535 W. MAIN STREET, SUITE 1 VILLE PLATTE, LA 70586(337) 363-5591
PHY GENERAL PRACTICE 770 2500 AGES 0 - 64
VIDRINE COMMUNITY CLINIC LLC 4940 VIDRINE ROAD VILLE PLATTE, LA 70586(337) 506-3500
PHY CLINIC OR OTHER GROUP PRACTICE
1369 5500 AGES 0 - 64; ACCEPTING PATIENTS AGES 0 - 20 ONLY
VIDRINE STEVEN 417 EAST LINCOLN ROAD VILLE PLATTE, LA 70586(337) 363-8033
PHY GENERAL PRACTICE 127 2500 CURRENT PATIENTS AGES 0 - 64
IBERIA JEANERETTE BOURGEOIS LEONARD 1409 CHURCH ST JEANERETTE, LA 70544(337) 276-6018
PHY FAMILY PRACTICE 44 2500 CURRENT PATIENTS AGES 6 - 64
Page Number: 37CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
IBERIA JEANERETTE JEANERETTE RURAL HEALTH CLINIC 217 BOURG STREET JEANERETTE, LA 70544(337) 276-7002
RHC RURAL HEALTH CLINIC
526 1000 AGES 0 - 64
ONG EDISON 303 BAYSIDE DR JEANERETTE, LA 70544(337) 276-5408
PHY FAMILY PRACTICE 457 2500 AGES 0 - 64
LOREAUVILLE
JAMES RUSSELL ROMERO MD 411 SOUTH MAIN LOREAUVILLE, LA 70552(337) 229-4214
RHC RURAL HEALTH CLINIC
360 1200 LIMITED PANEL; AGES 2 - 64
NEW IBERIA AHMAD MOUNAF 408 N LEWIS, SUITE 100-C NEW IBERIA, LA 70563(337) 365-0268
PHY PEDIATRICS 812 2500 OPEN AGES 0 - 4; CURRENT PATIENTS AGES 5 - 18
BOUDREAUX STEPHEN 520 N LEWIS ST STE 100NEW IBERIA, LA 70563(337) 364-3444
PHY GENERAL PRACTICE 98 2500 CURRENT PATIENTS AGES 0 - 64
CLARKE ANDREW 520 N LEWIS ST STE 203NEW IBERIA, LA 70563(337) 364-4738
PHY INTERNAL MEDICINE 18 2500 CURRENT PATIENTS AGES 21 - 64
COUSIN GEORGE 2309 EAST MAIN ST. SUITE 400 NEW IBERIA, LA 70563(337) 367-0271
PHY FAMILY PRACTICE 50 2500 CURRENT PATIENTS AGES 0 - 64
FAUGOT MAURICE 1100 ANDRE ST, SSTE 303 NEW IBERIA, LA 70563(337) 365-5437
PHY PEDIATRICS 275 400 LIMITED PANEL; CURRENT PTS & NEWBORNS AGES 0 - 20
GARCIA JESUS 1100 ANDRE ST STE 203NEW IBERIA, LA 70563(337) 367-6776
PHY FAMILY PRACTICE 33 2500 CURRENT PATIENTS AGES 0 - 64
IBERIA COMPREHENSIVE COMMUNITY HEALTH CENTER
806 JEFFERSON TERRACE BLVD. NEW IBERIA, LA 70560(337) 365-4945
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1705 10500 AGES 0 - 64
LAHASKY ROBERT 520 N. LEWIS ST, SUITE 203 NEW IBERIA, LA 70563(337) 364-4738
PHY FAMILY PRACTICE 63 2500 CURRENT PATIENTS AGES 0 - 64
MATA JOSE 2309 EAST MAIN ST. SUITE 400 NEW IBERIA, LA 70563(337) 367-0271
PHY FAMILY PRACTICE 41 2500 CURRENT PATIENTS AGES 0 - 64
Page Number: 38CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
IBERIA NEW IBERIA MENARD MICHELLE 2309 EAST MAIN STREET, STE 400 NEW IBERIA, LA 70560(337) 367-0271
PHY FAMILY PRACTICE 5 2500
MULLEN ELLEN 2312 E MAIN ST STE BNEW IBERIA, LA 70560(337) 364-0938
PHY FAMILY PRACTICE 45 2500 CLOSED PANEL
NUGENT JANICE 520 N LEWIS ST STE 204NEW IBERIA, LA 70563(337) 365-6251
PHY GENERAL PRACTICE 146 150 LIMITED PANEL; AGES 0 - 64
ODOM LEANDRE 2313 E. MAIN STREET, SUITE B NEW IBERIA, LA 70560(337) 560-5323
FAMILY PRACTICE 435 500 LIMITED PANEL; AGES 4 - 64
PALMIANO ALBERTO 2312 EAST MAIN ST, SUITE B NEW IBERIA, LA 70560(337) 364-0938
PHY FAMILY PRACTICE 107 250 CLOSED PANEL
PEDIATRIC GROUP OF ACADIANA LLC 520 N LEWIS STE 202NEW IBERIA, LA 70563(337) 367-2001
PHY 6990 10000 AGES 0 - 20; ACCEPTING NEW PTS AGES 0 - 18 ONLY
RADER ALLISON 408 N LEWIS ST STE 100-CNEW IBERIA, LA 70563(337) 365-0268
PHY PEDIATRICS 453 2500 OPEN AGES 0 - 4; CURRENT PATIENTS AGES 5 - 18
RAYMOND F SCHNEIDER MEMORIAL CLINIC
1302 ED BROUSSARD RD NEW IBERIA, LA 70563(337) 229-7929
RHC RURAL HEALTH CLINIC
144 1000 AGES 0 - 64
SAGRERA GEORGE 602 W. ST PETER STREET NEW IBERIA, LA 70560(337) 364-8196
PHY GENERAL PRACTICE 74 2500 CURRENT PATIENTS AGES 0 - 64
THE CHILDREN'S CENTER 2315 EAST MAIN STREET NEW IBERIA, LA 70560(337) 374-7589
PHY 1803 5000 AGES 0 - 18
THE CHILDREN'S PRACTICE 2308 EAST MAIN STREET NEW IBERIA, LA 70560(337) 560-5005
PHY 3873 5000 AGES 0 - 18
VIATOR TIMOTHY 2205 OLD JEANERETTE ROAD NEW IBERIA, LA 70563(337) 364-8566
PHY FAMILY PRACTICE 275 2500 AGES 21 - 64
Page Number: 39CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LAFAYETTE CARENCRO KENNEDY MICHAEL 111 ST CHARLES STREET CARENCRO, LA 70520(337) 886-1200
PHY FAMILY PRACTICE 634 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 64
NGUYEN NHU-VONG 208 NORTH CHURCH STREET CARENCRO, LA 70520(337) 896-4090
PHY FAMILY PRACTICE 944 2500 AGES 6 MTHS - 64 YRS
PEDIATRIC GROUP OF ACADIA 4141 N. UNIVERSITY AVENUE CARENCRO, LA 70520(337) 565-2692
PHY 140 2500
DUSON DUSON FAMILY HEALTHCARE 9023 CAMERON STREET DUSON, LA 70529(337) 873-8244
NP FAMILY PRACTICE 713 1000 AGES 0 - 64
LAFAYETTE AHS WALK IN CLINIC 1602 W PINHOOK ROAD, STE 100 LAFAYETTE, LA 70508(337) 234-9925
PHY CLINIC OR OTHER GROUP PRACTICE
370 2500 AGES 2 - 64
BARES GEORGE 4650 AMBASSADOR CAFFERY,#206 LAFAYETTE, LA 70508(337) 988-2345
PHY PEDIATRICS 424 2500 CURRENT PATIENTS AGES 0 - 20
BRUNO CARLOS 811 ALBERTSONS PKWY SUITE ALAFAYETTE, LA 70508(337) 839-2265
PHY PEDIATRICS 696 2500 CURRENT, SIBLINGS & NEWBORNS SEEN @ HOSP AGES 0-20
BRYAN G SIBLEY MD APMC 1211 COOLIDGE BLVD, SUITE 300 LAFAYETTE, LA 70503(337) 289-0042
PHY CLINIC OR OTHER GROUP PRACTICE
2406 3000 AGES 0 - 14; ACCEPTS NEW PATIENTS AGES 0 - 10 ONLY
CHRISTY LAWRENCE W 600 EAST THIRD ST LAFAYETTE, LA 70501(337) 232-8814
PHY PEDIATRICS 2070 2500 AGES 0 - 18
GRANGER BRIAN 201 W GLORIA SWITCH RD, STE I LAFAYETTE, LA 70507(337) 565-6012
PHY FAMILY PRACTICE 18 50 CLOSED PANEL
HAMILTON MEDICAL GROUP-FAMILY PRACTICE MAIN
4212 WEST CONGRESS LAFAYETTE, LA 70506(337) 988-8810
PHY 6 7500 CLOSED PANEL
HAMILTON MEDICAL GROUP-FAMILY PRACTICE NORTH
3414 MOSS STREET LAFAYETTE, LA 70507(337) 232-0038
PHY 23 2500 CLOSED PANEL
Page Number: 40CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LAFAYETTE LAFAYETTE HAMILTON MEDICAL GROUP-PEDIATRIC 4540 AMB CAFFERY PKWY,STE B220 LAFAYETTE, LA 70508(337) 984-2444
PHY 70 2500 CLOSED PANEL
JAMES MWATIBO & JOHNNY S THIBODEAUX
850 NORTH PIERCE ST, SUITE D LAFAYETTE, LA 70501(337) 233-2115
PHY CLINIC OR OTHER GROUP PRACTICE
187 5000 CLOSED PANEL
JOLIVETTE MILTON 501 W. ST.MARY BLVD, STE 300 LAFAYETTE, LA 70506(337) 234-1945
PHY INTERNAL MEDICINE 20 2500 CURRENT PATIENTS AGES 21 - 64
LAFAYETTE CHILDRENS CLINIC LLC 5000 AMBASSADOR CAFF PKWY #12 LAFAYETTE, LA 70508(337) 989-5061
PHY CLINIC OR OTHER GROUP PRACTICE
174 7500 CURRENT PATIENTS AGES 0 - 18
LEBEAN BRYAN 2930 MOSS STREET, SUITE B LAFAYETTE, LA 70501(337) 261-0559
PHY INTERNAL MEDICINE 30 2500 CURRENT PATIENTS AGES 21 - 64
LEBRON-BERGES ALFREDO 4540 AMBASSADOR CAFFERY S B130 LAFAYETTE, LA 70508(337) 981-8486
PHY PEDIATRICS 1393 2000 CURRENT PATIENTS AND NEWBORNS AGES 0 - 18
LOUIS CHARLES 3911 MOSS STREET LAFAYETTE, LA 70501(337) 262-0091
PHY CARDIOVASCULAR DISEASE
57 2500 CURRENT PATIENTS AGES 12 - 64
LSUHN-UMC FAMILY PRACTICE 2390 WEST CONGRESS STREET LAFAYETTE, LA 70506(337) 261-6655
PHY 1658 20000 AGES 0 - 64
LSUHN-UMC MEDICINE 2390 WEST CONGRESS STREET LAFAYETTE, LA 70506(337) 261-6100
PHY 856 10000 AGES 18 - 64
LSUHN-UMC PEDIATRICS 2390 WEST CONGRESS STREET LAFAYETTE, LA 70506(337) 261-6565
PHY 2851 15000 AGES 0 - 18
MANUEL MEDICAL CLINIC 104 GENEVIEVE DRIVE LAFAYETTE, LA 70503(337) 984-0110
PHY 1820 3000 AGES 0 - 20
MELANCON MICHAEL 4650 AMBASSADOR CAFF STE 105LAFAYETTE, LA 70508(337) 989-8080
PHY PEDIATRICS 330 2500 CURRENT PATIENTS & NEWBORNS AGES 0 - 17
Page Number: 41CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LAFAYETTE LAFAYETTE MICHAEL K JUDICE MD LTD APMC 4630 AMBASSADOR CAF PY STE 102LAFAYETTE, LA 70508(337) 989-2322
PHY CLINIC OR OTHER GROUP PRACTICE
273 10000 CURRENT PATIENTS AGES 0 - 17
MOORE PATRICK 3400 MOSS ST LAFAYETTE, LA 70507(337) 706-8986
PHY FAMILY PRACTICE 47 2500 AGES 0 - 64
MOSS STREET KIDMED 1417 MOSS STREET STE.A LAFAYETTE, LA 70501(337) 291-2411
PHY CLINIC OR OTHER GROUP PRACTICE
2873 3000 AGES 0 - 64
PEDIATRIC GROUP OF ACADIANA 1002 TWELFTH STREET LAFAYETTE, LA 70501(337) 534-0107
PHY 159 2500
PEDIATRIC GROUP OF ACADIANA LLC 410 YOUNGSVILLE HWY, STE 100 LAFAYETTE, LA 70508(337) 330-0031
PHY 4185 5000 AGES 0 - 18
ROBINSON DARRELL 4630 AMBASSADOR CAFFERY, #214 LAFAYETTE, LA 70508(337) 981-6969
PHY OB/GYN 444 1000 LIMITED PANEL; FEMALES ONLY, AGES 12 - 64
SMITH KAREN 601 W ST MARY BLVD, STE 403 LAFAYETTE, LA 70506(337) 233-3731
PHY INTERNAL MEDICINE 2 2500 CURRENT PATIENTS AGES 21 - 64
SWLA CENTER FOR HEALTH SERVICE 716 HELLEN STREET LAFAYETTE, LA 70501(337) 769-9451
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
474 5000 AGES 0 - 64
WILLIAMS-SR GERARD 901 W. GLORIA SWITCH ROAD LAFAYETTE, LA 70507(337) 886-0023
PHY INTERNAL MEDICINE 1096 2500 OPEN AGES BIRTH - 2 M; CURRENT PTS AGES 3M - 64YRS
SCOTT ACADIA WALK-IN CLINIC 6100 CAMERON STREET SCOTT, LA 70583(337) 289-6770
PHY CLINIC OR OTHER GROUP PRACTICE
1612 5000 AGES 0 - 20
SCOTT FAMILY CLINIC 5935 CAMERON ST SCOTT, LA 70583(337) 264-0326
PHY CLINIC OR OTHER GROUP PRACTICE
940 1000 AGES 0 - 64
YOUNGSVILLE
LAURENTE SARAH 814 FORTUNE RD STE 108YOUNGSVILLE, LA 70592(337) 857-5096
PHY PEDIATRICS 890 900 LIMITED PANEL; AGES 0 - 18
Page Number: 42CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. LANDRY CANKTON FLEUR-DE-LIS COMMUNITY HEALTH CENTER
376 MAIN STREET CANKTON, LA 70584(337) 668-4141
RHC RURAL HEALTH CLINIC
593 2000 AGES 0 - 64
EUNICE BEAUCHAMP-ROCHE KERMEN 3521 HWY 190, STE R EUNICE, LA 70535(337) 457-2301
PHY PEDIATRICS 1040 2500 AGES 0 - 17
FITZGERALD STEPHEN 151 HILL ST STE 2EUNICE, LA 70535(337) 457-4415
PHY INTERNAL MEDICINE 124 2500 AGES 21 - 64
HEBERT MEDICAL GROUP AMC 3521 HWY 190, STE S EUNICE, LA 70535(337) 550-8530
PHY CLINIC OR OTHER GROUP PRACTICE
732 12500 AGES 0 - 18; ACCEPTS NEWBORNS AGES 0 - 2 MNTH ONLY
HEINEN JADE 151 LEON STREET EUNICE, LA 70535(337) 457-8166
PHY FAMILY PRACTICE 46 200 AGES 21 - 64
HEINEN OBSTETRICS & GYNECOLOGY 3448 HWY 190 EUNICE, LA 70535(337) 546-6237
PHY CLINIC OR OTHER GROUP PRACTICE
98 100 LIMITED PANEL; FEMALE ONLY AGES 21 - 45
PULLIN TODD 3521 HWY 190 E STE. NEUNICE, LA 70535(337) 550-1175
PHY PEDIATRICS 1462 2500 OPEN AGES 0 - 6; CURRENT PTS & SIBLINGS AGES 7 -20
ROBINSON JULIET 3521 HWY 190 STE VEUNICE, LA 70535(337) 550-0405
PHY FAMILY PRACTICE 69 2500 CURRENT PATIENTS AGES 10 - 64
SAVOY FAMILY CARE 102 S. 2ND STREET EUNICE, LA 70535(337) 457-7798
RHC RURAL HEALTH CLINIC
1882 5500 AGES 0 - 64
STEARNS ZEBEDIAH 450 MOOSA BLVD, SUITE A EUNICE, LA 70535(337) 546-6646
PHY FAMILY PRACTICE 97 500 CLOSED PANEL
WARE DAVID 3521 HIGHWAY 190, STE P EUNICE, LA 70535(337) 457-8040
PHY FAMILY PRACTICE 57 2500 CLOSED PANEL
OPELOUSAS ALAM USMAN 611 E PRUDHOMME ST.,STE.3 OPELOUSAS, LA 70570(337) 942-5750
PHY CARDIOVASCULAR DISEASE, INTERNAL MEDICINE
50 2500 CLOSED PANEL
Page Number: 43CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. LANDRY OPELOUSAS ALL KIDS PEDIATRIC OF OPELOUSAS 920 NORTH MAIN STREET OPELOUSAS, LA 70570(337) 407-8697
PHY CLINIC OR OTHER GROUP PRACTICE
2385 2500 MAX CAP EXCEEDED; ACCEPTS AGES 0-2M;CURR PTS 3M-18
BERTRAND CHARLES 611 E PRUDHOMME STREET,SUITE 5 OPELOUSAS, LA 70570(337) 942-5899
PHY PEDIATRICS 1290 2500 AGES 0 - 20
BOULET JR. L.H. 8676 HIGHWAY 182 OPELOUSAS, LA 70570(337) 942-6324
PHY GENERAL PRACTICE 28 2500 CLOSED PANEL
CHATMAN ERIC 1200 HOSPITAL DR STE 5OPELOUSAS, LA 70570(337) 948-8269
PHY INTERNAL MEDICINE 34 2500 CURRENT PATIENTS AGES 14 - 64
FAMILY CLINIC INC 3921 I-49 SOUTH SERVICE RD. OPELOUSAS, LA 70570(337) 942-5706
PHY CLINIC OR OTHER GROUP PRACTICE
686 10000 AGES 0 - 18; CURRENT PATIENTS AGES 19 - 64
GLOWACKI GREGORY 1200 HOSPITAL DRIVE STE. 2 OPELOUSAS, LA 70570(337) 942-4453
PHY PEDIATRICS 1885 2500 AGES 0 - 20
GREAT BEGINNINGS PEDIATRICS & ADOLESCENT MEDICINE
3975 I-49 S. SERVICE RD STE201 OPELOUSAS, LA 70570(337) 407-2795
PHY CLINIC OR OTHER GROUP PRACTICE
2660 3000 AGES 0 - 18
GREENE CRAIG 2967 S. UNION STREET OPELOUSAS, LA 70570(337) 594-8958
PHY GENERAL PRACTICE 175 2500 CURRENT PATIENTS AGES 0 - 64
GUIDRY JOHN 3975 I 49 S SERVICE RD SU 230OPELOUSAS, LA 70570(337) 948-4019
PHY INTERNAL MEDICINE 10 2500 CURRENT PATIENTS AGES 21 - 64
JONES-III THOMAS 1200 HOSPITAL DR STE 2OPELOUSAS, LA 70570(337) 942-4453
PHY PEDIATRICS 2088 2500 AGES 0 - 20
KOUBICEK CARMEN 1270 ATTAKAPAS DR STE 401KOPELOUSAS, LA 70570(337) 407-0084
PHY PEDIATRICS 1239 2500 OPEN AGES 0 - 2 M; CURRNT PTS & SIBLINGS 3M - 18YR
METOYER MEDICAL CORPORATION INC FAMILY PRACTICE
204 W NORTH ST OPELOUSAS, LA 70570(337) 948-4445
PHY CLINIC OR OTHER GROUP PRACTICE
385 5500 AGES 21 - 64
Page Number: 44CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. LANDRY OPELOUSAS RICHARD ARLENE 507 N MARKET ST. OPELOUSAS, LA 70570(337) 948-1212
PHY FAMILY PRACTICE 145 2500 CURRENT PATIENTS AGES 21 - 64
SANCHEZ LURIS 828 CRESWELL LANE OPELOUSAS, LA 70570(337) 942-8088
PHY FAMILY PRACTICE 254 2500 AGES 0 - 64; ACCEPTING NEW PTS AGES 0 - 21 ONLY
SW LA PRIMARY HEALTH CARE 8762 HIGHWAY 182 OPELOUSAS, LA 70570(337) 942-2005
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
898 3000 AGES 0 - 64
TINUBU ADENIKE 1119 PRUDHOMME CIRCLE OPELOUSAS, LA 70570(337) 942-1320
PHY FAMILY PRACTICE 508 2500 AGES 21 - 64
WHITE CALVIN 1119 PRUDHOMME CIRCLE OPELOUSAS, LA 70570(337) 942-1320
PHY FAMILY PRACTICE 193 200 CLOSED PANEL
PORT BARRE FANDAL-JR FREDDIE 17695 US HIGHWAY 190 PORT BARRE, LA 70577(337) 585-7898
PHY FAMILY PRACTICE 466 2500 OPEN PANEL AGES 0 - 20; BLOCKED PANEL AGES 21 - 64
MAYEAUX STACEY 17695 HWY 190 PORT BARRE, LA 70577(337) 585-7898
PHY FAMILY PRACTICE 171 2500 AGES 0 - 20
SUNSET SUNSET MEDICAL CLINIC INC 990 NAPOLEON AVE SUNSET, LA 70584(337) 662-5248
PHY CLINIC OR OTHER GROUP PRACTICE
1047 7500 AGES 6M - 18Y; CURRENT PTS & SIBLINGS AGES 19 - 64
WASHINGTON
GILLESPIE PATRICK 414 NORTH MAIN STREET WASHINGTON, LA 70589(337) 826-8044
PHY FAMILY PRACTICE 148 150 MAX CAPACITY EXCEEDED; LIMITED PANEL;CURR PTS 0-64
ST. MARTIN BREAUX BRIDGE
MED ED OF LOUISIANA INC 206 CHAMPAGNE BLVD STE BBREAUX BRIDGE, LA 70517(337) 332-0222
PHY CLINIC OR OTHER GROUP PRACTICE
1808 3000 AGES 0 - 20 & AGES 50-64; CURRENT PTS AGES 21-49
PEDIATRIC GROUP OF ACADIANA 1442 EAST BRIDGE ST BUILDING CBREAUX BRIDGE, LA 70517(337) 332-3971
PHY 1789 2500 AGES 0 - 21
ST MARTINVILLE
ST MARTIN PARISH COMMUNITY HEALTH
317 DERINER STREET ST MARTINVILLE, LA 70582(337) 342-2566
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
348 3000 AGES 0 - 64
Page Number: 45CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. MARTIN ST MARTINVILLE
ST MARTINVILLE MATERNAL-CHILD CLINIC
1119 N MAIN ST ST MARTINVILLE, LA 70582(337) 394-7774
RHC RURAL HEALTH CLINIC
2438 3000 OPEN AGES 0 - 18; FEMALES ONLY AGES 19 - 64
WILTZ DANIEL 1117 N. MAIN ST, SUITE B ST MARTINVILLE, LA 70582(337) 394-7111
PHY FAMILY PRACTICE 18 2500 CLOSED PANEL
VERMILION ABBEVILLE ABBEVILLE COMMUNITY HEALTH CENTER
800 CHARITY STREET ABBEVILLE, LA 70510(337) 893-3443
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
545 3000 AGES 0 - 64
ABBEVILLE GENERAL HOSPITAL CLINIC 2419 ALONZO ST. ABBEVILLE, LA 70510(337) 892-0630
RHC RURAL HEALTH CLINIC
554 7500 AGES 2 - 64
GUTPA PADMINI 323 ODEA ABBEVILLE, LA 70510(337) 898-9503
PHY 452 2500 AGES 0 - 20
MANUEL MEDICAL CLINIC 2405 ALONZO ABBEVILLE, LA 70510(337) 893-3722
PHY 2746 3000 AGES 0 - 20
PEDIATRIC GROUP OF ACADIANA LLC 1049 WEST SUMMERS DR ABBEVILLE, LA 70510(337) 422-6240
PHY 953 2500 AGES 0 - 20
GUEYDAN GARDINER CENTER HEALTH CLINIC 710 FIFTH STREET GUEYDAN, LA 70542(337) 536-9262
RHC RURAL HEALTH CLINIC
239 1000 AGES 0 - 64
KAPLAN BERGEAUX SCOTT 1402 W 8TH STREET KAPLAN, LA 70548(337) 643-6219
PHY FAMILY PRACTICE 331 2500 AGES 1 - 64
GUPTA PADMINI 801 MONTGOMERY KAPLAN, LA 70548(337) 643-8400
PHY 574 2500 AGES 0 - 20
LELEUX PATRICK 202 N. JACKSON AVE KAPLAN, LA 70548(337) 643-1655
PHY EMERGENCY MEDICINE
41 2500 AGES 21 - 64
PATEL SURESHCHAND 804 N MONCEAUX KAPLAN, LA 70548(337) 643-1525
PHY INTERNAL MEDICINE 29 50 LIMITED PANEL; VERMILION PARISH ONLY AGES 21 - 64
Page Number: 46CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 4
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
VERMILION KAPLAN TATE DAVID 109 EAST FIFTH STREET KAPLAN, LA 70548(337) 643-8096
PHY FAMILY PRACTICE 448 2500 AGES 0 - 64
MAURICE MAURICE COMMUNITY CARE CLINIC 207 MILTON RD MAURICE, LA 70555(337) 898-9449
RHC RURAL HEALTH CLINIC
372 6000 AGES 2 - 64
Page Number: 47CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
ACADIA OTHER 4
PEDIATRICS 2
INTERNAL 2
RHC 1
GENERAL PRACTICE
1
FAMILY PRACTICE 4
OB/GYN 2
TOTAL: 16 41,280 10,453
EVANGELINE GENERAL PRACTICE
7
PEDIATRICS 2
INTERNAL 5
OTHER 3
FAMILY PRACTICE 2
TOTAL: 19 51,000 6,910
IBERIA OTHER 3
INTERNAL 1
FQHC 1
GENERAL PRACTICE
3
FAMILY PRACTICE 11
PEDIATRICS 3
RHC 3
TOTAL: 25 70,000 18,832
LAFAYETTE OB/GYN 1
CommunityCARE Provider Summary Count By ParishREGION 4
Page Number: 48CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
LAFAYETTE PEDIATRICS 6
OTHER 19
FQHC 1
FAMILY PRACTICE 5
INTERNAL 4
TOTAL: 36 147,450 30,885
ST. LANDRY FAMILY PRACTICE 11
PEDIATRICS 6
FQHC 1
OTHER 7
GENERAL PRACTICE
2
INTERNAL 4
RHC 2
TOTAL: 33 100,150 22,945
ST. MARTIN FAMILY PRACTICE 1
RHC 1
OTHER 2
FQHC 1
TOTAL: 5 14,000 6,401
VERMILION OTHER 5
FAMILY PRACTICE 2
INTERNAL 1
FQHC 1
RHC 3
TOTAL: 12 35,550 7,284
REGION TOTALS 146 459,430 103,710
Page Number: 49CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 5
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ALLEN ELIZABETH ELIZABETH FAMILY HEALTH CLINIC 504 W MAIN ELIZABETH, LA 70638(318) 634-5475
RHC RURAL HEALTH CLINIC
291 1000 AGES 0 - 64
KINDER ALLEMAND PEGGY 208 6TH AVE. SUITE 5 KINDER, LA 70648(337) 738-2713
PHY FAMILY PRACTICE 131 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 64
ALLEN PARISH HOSPITAL RURAL HEALTH
108 6TH AVENUE KINDER, LA 70648(337) 738-9494
RHC RURAL HEALTH CLINIC
843 3000 AGES 0 - 64
OAKDALE DAVIS-JR THOMAS 105 N HOSPITAL DRIVE OAKDALE, LA 71463(318) 335-4321
PHY FAMILY PRACTICE 141 2500 CURRENT PATIENTS AGES 0 - 64
GHANTA MADHUSUDANA 115 HOSPITAL DRIVE OAKDALE, LA 71463(318) 335-4393
PHY FAMILY PRACTICE 1436 2500 AGES 0 - 64
RAPIDES REGIONAL PHYSICIAN GROUP 400 E SIXTH AVE OAKDALE, LA 71463(318) 335-4881
PHY CLINIC OR OTHER GROUP PRACTICE
845 5000 AGES 0 - 64
OBERLIN NAZIM MUHAMMAD 616 COURT STREET OBERLIN, LA 70655(337) 639-2500
PHY FAMILY PRACTICE 228 2500 AGES 0 - 64
BEAUREGARD DERIDDER BONILLA EDWIN 403 WEST EIGHTH STREET DERIDDER, LA 70634(337) 463-8977
PHY FAMILY PRACTICE 12 2500 CLOSED PANEL
CARTER HENRY 305 WEST 7TH STREET STE C DERIDDER, LA 70634(337) 463-4800
PHY INTERNAL MEDICINE 5 2500 CLOSED PANEL
DOBBINS THOMAS 325 WEST EIGHTH STREET DERIDDER, LA 70634(337) 463-3387
PHY PEDIATRICS 792 2500 AGES 0 - 64; NO NEW PATIENTS OVER AGE 1
DUPLECHAIN RANDALL 701 SOUTH PINE ST DERIDDER, LA 70634(337) 462-1080
PHY FAMILY PRACTICE 160 2500 CURRENT PATIENTS AGES 0 - 64
GRANGER CHRISTOPHER 403 WEST 8TH STREET DERIDDER, LA 70634(337) 463-8977
PHY GENERAL PRACTICE 52 300 CLOSED PANEL
Page Number: 50CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 5
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
BEAUREGARD DERIDDER GRIFFIN THOMAS 200 WEST FIFTH ST DERIDDER, LA 70634(337) 463-3176
PHY PEDIATRICS 1292 2500 OPEN AGES 0 - 12 MONTHS ; CURRENT PTS AGES 1 - 18
PANDYA MAHESH 603 SOUTH PINE STREET DERIDDER, LA 70634(337) 463-2172
PHY INTERNAL MEDICINE 2 2500 CURRENT PATIENTS AGES 21 - 64
PELICAN PEDIATRICS 101 W. 6TH STREET DERIDDER, LA 70634(337) 462-8636
PHY 319 5000
PERKINS MICHAEL 813 BON AMI ST DERIDDER, LA 70634(337) 462-6000
PHY PEDIATRICS 1727 2500 AGES 0 - 20; ACCEPTING NEW PTS AGES 0 - 17 ONLY
TAYLOR FLYNN 412 SOUTH PINE STREET DERIDDER, LA 70634(337) 463-9890
PHY FAMILY PRACTICE 568 2500 AGES 0 - 64
MERRYVILLE MERRYVILLE COMMUNITY HEALTH 567 WALKER STREET MERRYVILLE, LA 70653(337) 825-1728
FQHC 69 3000
CALCASIEU DEQUINCY ADAMSON FATAI 128 W FOURTH ST DEQUINCY, LA 70633(337) 786-3913
PHY PEDIATRICS 693 2500 AGES 0 - 20
CHADHA MEDICAL CLINIC 140 W FOURTH ST DEQUINCY, LA 70633(337) 786-5007
RHC RURAL HEALTH CLINIC
740 5500 AGES 0 - 64
DEQUINCY MEDICAL CLINIC LLC 601 WEST 4TH STREET DEQUINCY, LA 70633(337) 786-6161
PHY CLINIC OR OTHER GROUP PRACTICE
397 2500 AGES 6 - 64
JACOBS ERIC 122 WEST FOURTH STREET DEQUINCY, LA 70633(337) 786-3030
PHY FAMILY PRACTICE 513 2500 AGES 0 - 64
IOWA IOWA HEALTH CENTER 203 E. MILLER AVE SUITE BIOWA, LA 70647(337) 582-7632
RHC RURAL HEALTH CLINIC
405 3000 ONLY RESIDENTS OF CALCASIEU&JEFFDAVIS PAR AGES3-21
LAKE CHARLES
ADEOSUN ANTHONY 333 S RYAN ST STE 120LAKE CHARLES, LA 70601(337) 493-8480
PHY FAMILY PRACTICE 538 2500 AGES 0 - 64
Page Number: 51CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 5
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CALCASIEU LAKE CHARLES
BERGSTEDT JENNETTE 4150 NELSON RD,BLD E,STE.1 LAKE CHARLES, LA 70605(337) 474-2933
PHY PEDIATRICS 400 2500 CLOSED PANEL
BREAUX ADRIENNE 711 DR.MICHAEL DEBAKEY DR #600 LAKE CHARLES, LA 70601(337) 491-7072
PHY INTERNAL MEDICINE 211 2500 OPEN BIRTH TO 1MO; CURR PTS & SIBLINGS AGES 2M-18Y
CHATTERS RACHEL 1935 SOUTHWOOD DRIVE LAKE CHARLES, LA 70605(337) 475-9009
PHY PEDIATRICS 1939 2500 0 - 2 MTHS; 3 MTHS - 18 CURRENT PTS & PREM BABIES
CHILDREN'S CLINIC OF SW LA 2903 FIRST AVENUE LAKE CHARLES, LA 70601(337) 478-6480
PHY CLINIC OR OTHER GROUP PRACTICE
9473 30500 CURRENT PATIENTS AGES 0 - 20
CHRISTUS MEDICAL GROUP 711 DR. MICHAEL DEBAKEY DRIVE LAKE CHARLES, LA 70601(337) 439-2200
PHY CLINIC OR OTHER GROUP PRACTICE
277 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 18
FAMILY MEDICINE CENTER 2750 ASTER STREET LAKE CHARLES, LA 70601(337) 478-2650
PHY 8 12500
JONES SUSAN 2708 SECOND AVE STE CLAKE CHARLES, LA 70601(337) 474-0046
PHY INTERNAL MEDICINE 35 2500 CURRENT PATIENTS AGES 21 - 64
LSUMC-S FAMILY PRACTICE CENTER L.C.
1525 OAK PARK BLVD LAKE CHARLES, LA 70601(337) 494-6767
PHY CLINIC OR OTHER GROUP PRACTICE
1224 2500 OPEN AGES 0 - 18; CURR PTS AGES 19 - 64 & OB PTS
PRIMARY CARE CLINIC - W.O. MOSS 1000 WALTERS STREET LAKE CHARLES, LA 70607(337) 475-8066
PHY CLINIC OR OTHER GROUP PRACTICE
1047 12500 AGES 14 - 64
ROSS CARL 410 LOUISIANA AVENUE LAKE CHARLES, LA 70601(337) 439-4923
PHY GENERAL PRACTICE 389 2500 AGES 21 - 64
ROY ANAND 760 E BAYOU PINES LAKE CHARLES, LA 70601(337) 433-0313
PHY INTERNAL MEDICINE, INTERNAL MEDICINE
106 1000 AGES 6 MONTHS - 64 YEARS
SANDERS RICHARD 277 HWY 171 N. SUITE 8 LAKE CHARLES, LA 70611(337) 312-0030
PHY FAMILY PRACTICE 637 2500 AGES 0 - 64; ACCEPTING NEW PTS AGES 0 - 20 ONLY
Page Number: 52CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 5
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CALCASIEU LAKE CHARLES
SWLA CENTER FOR HEALTH SERVICE 2000 OPELOUSAS STREET LAKE CHARLES, LA 70601(337) 439-9983
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
3700 19500 AGES 0 - 64
THE PEDIATRIC CENTER OF SOUTHWEST LOUISIANA
1920 WEST SALE ROAD, SUITE F7 LAKE CHARLES, LA 70605(337) 477-0935
PHY 868 2500 OPEN 0 - 15; CURRENT PTS AGES 16 - 64
WO MOSS REGIONAL MEDICAL 1000 WALTERS STREET LAKE CHARLES, LA 70607(337) 475-8420
PHY CLINIC OR OTHER GROUP PRACTICE
1144 2500 AGES 0 - 13
SULPHUR CALCASIEU FAMILY PHYSICIANS 920 1ST AVENUE SULPHUR, LA 70663(337) 528-7472
PHY CLINIC OR OTHER GROUP PRACTICE
211 5000 AGES 0 - 64
SMITH GEORGE 1908 MAPLEWOOD DRIVE, SUITE B SULPHUR, LA 70663(337) 625-5050
PHY FAMILY PRACTICE 367 2500 AGES 0 - 64
THE MAGNOLIA CLINIC 914 SOUTH POST OAK ROAD SULPHUR, LA 70663(337) 625-0035
PHY CLINIC OR OTHER GROUP PRACTICE
771 1000 CURRENT PATIENTS, NEWBORNS, & SIBLINGS AGES 0 - 20
THE PEDIATRIC CENTER OF SOUTHWEST LOUISIANA
600 CYPRESS STREET SULPHUR, LA 70663(337) 527-6371
PHY 4950 11000 OPEN AGES 0 - 16; CURRENT PTS AGES 17 - 20
VINTON VINTON MEDICAL CLINIC 1611 HAMPTON ST. VINTON, LA 70668(337) 589-5951
RHC RURAL HEALTH CLINIC
292 3500 AGES 0 - 64
WESTLAKE THE FAMILY CARE CENTER OF SWL 2345 SAMPSON STREET WESTLAKE, LA 70669(337) 439-1484
PHY CLINIC OR OTHER GROUP PRACTICE
125 128 LIMITED PANEL; AGES 0 - 18; CURR PTS AGES 19 - 64
CAMERON HACKBERRY HACKBERRY RURAL HEALTH CLINIC 1020 MAIN STREET HACKBERRY, LA 70645(337) 762-3762
RHC RURAL HEALTH CLINIC
220 1000 AGES 0 - 64
JEFFERSON DAVIS
ELTON ELTON RURAL HEALTH CLINIC 907 MAIN STREET ELTON, LA 70532(337) 584-2237
RHC RURAL HEALTH CLINIC
482 2500 AGES 0 - 64
JENNINGS APELLANIZ LUIS 1322 ELTON HWY, SUITE P JENNINGS, LA 70546(337) 824-3446
PHY PEDIATRICS 1677 2500 AGES 0 - 21
Page Number: 53CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 5
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
JEFFERSON DAVIS
JENNINGS CLAWSON MARK 805 NORTH STATE STREET JENNINGS, LA 70546(337) 824-8099
PHY FAMILY PRACTICE 658 2500 CURRENT PATIENTS & FAMILY MEMBERS AGES 0 - 64
JEFF DAVIS FAMILY MEDICINE APMC 1322 ELTON ROAD STE D JENNINGS, LA 70546(337) 824-1111
PHY CLINIC OR OTHER GROUP PRACTICE
698 7500 CURRENT PATIETNS AGES 0 - 64
LACOMB FAMILY MEDICINE 1322 ELTON HWY STE FJENNINGS, LA 70546(337) 824-8868
PHY CLINIC OR OTHER GROUP PRACTICE
1251 2500 AGES 0 - 64
SEGURA JOHN 1636 ELTON ROAD, SUITE 204 JENNINGS, LA 70546(337) 824-7833
PHY FAMILY PRACTICE 50 2500
LAKE ARTHUR
LAKE ARTHUR HEALTH CLINIC 328 KELLOGG STREET LAKE ARTHUR, LA 70549(337) 774-0100
RHC RURAL HEALTH CLINIC
210 1000 CLOSED PANEL
WELSH KANG YOUNG 107 SOUTH ELMS STREET WELSH, LA 70591(337) 734-4730
PHY GENERAL PRACTICE 414 2500 AGES 0 - 64
KRIELOW YVONNE 708 E RUSSELL WELSH, LA 70591(337) 734-4500
NP FAMILY PRACTICE 309 1000 CURRENT PATIENTS & SIBLINGS AGES 0 - 64
WELSH FAMILY PRACTICE CLINIC INC 308 SOUTH PALMER WELSH, LA 70546(337) 734-4901
PHY CLINIC OR OTHER GROUP PRACTICE
351 500 CLOSED PANEL
Page Number: 54CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
ALLEN OTHER 1
FAMILY PRACTICE 4
RHC 2
TOTAL: 7 19,000 3,915
BEAUREGARD OTHER 2
FAMILY PRACTICE 3
PEDIATRICS 3
INTERNAL 2
GENERAL PRACTICE
1
TOTAL: 11 28,300 4,998
CALCASIEU OTHER 12
FAMILY PRACTICE 4
INTERNAL 3
GENERAL PRACTICE
1
PEDIATRICS 3
FQHC 1
RHC 3
TOTAL: 27 142,628 31,460
CAMERON RHC 1
TOTAL: 1 1,000 220
JEFFERSON DAVIS GENERAL PRACTICE
1
OTHER 3
FAMILY PRACTICE 3
CommunityCARE Provider Summary Count By ParishREGION 5
Page Number: 55CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
JEFFERSON DAVIS PEDIATRICS 1
RHC 2
TOTAL: 10 25,000 6,100
REGION TOTALS 56 215,928 46,693
Page Number: 56CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
AVOYELLES BUNKIE BUNKIE GENERAL HOSPITAL FAMILY CARE CLINIC
510 S. COTTONWOOD ST. BUNKIE, LA 71322(318) 346-3339
RHC RURAL HEALTH CLINIC
989 3000 AGES 0 - 64
BUNKIE GENERAL HOSPITAL RURAL HEALTH CLINIC
109 N LEXINGTON AVE BUNKIE, LA 71322(318) 346-7283
RHC RURAL HEALTH CLINIC
649 3000 AGES 0 - 64
COTTONPORT
COTTONPORT FAMILY CLINIC 912 BRYAN ST COTTONPORT, LA 71327(318) 876-3696
RHC RURAL HEALTH CLINIC
1343 1000 MAX CAPACITY EXCEEDED; AGES 0 - 64
MANSURA MANSURA FAMILY CLINIC 2104 CLECO ST MANSURA, LA 71350(318) 964-2551
RHC RURAL HEALTH CLINIC
344 1000 AGES 0 - 64
MARKSVILLE GAGIC PREDRAG 313 CENTER ST MARKSVILLE, LA 71351(318) 253-8655
PHY GENERAL SURGERY 3 2500 CURRENT PATIENTS AGES 21 - 64
GOUX VINCENT 597 TUNICA DR MARKSVILLE, LA 71351(318) 253-7511
PHY FAMILY PRACTICE 207 2500 AGES 0 - 20
MANSOOR PEDIATRICS/AVOYE 338 MOREAU STREET, SUTIE C MARKSVILLE, LA 71351(318) 253-7022
PHY 112 1000
MARKSVILLE FAMILY CARE CENTER 5541 HIGHWAY 1 MARKSVILLE, LA 71351(318) 240-7240
RHC RURAL HEALTH CLINIC
2325 3500 AGES 0 - 64
MCCANN D ARRON 424 N WASHINGTON ST MARKSVILLE, LA 71351(318) 253-1788
PHY FAMILY PRACTICE 361 2500 NEW PTS AGES 0 - 20; CURRENT PATIENTS AGES 21 - 64
MOUNAYAR ELIAS 338 MOREAU STREET, SUITE D MARKSVILLE, LA 71351(318) 253-5600
PHY INTERNAL MEDICINE 267 2500 AGES 0 - 64
SIMMESPORT
KD HEALTH & WELLNESS CENTER 118 JJJ LN SIMMESPORT, LA 71369(318) 941-5286
RHC RURAL HEALTH CLINIC
243 1000 AGES 0 - 64
KUPLESKY STEPHEN 314 CHRISTNE LANE SIMMESPORT, LA 71369(318) 941-2057
PHY GENERAL PRACTICE 268 2500 AGES 0 - 64
Page Number: 57CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
AVOYELLES SIMMESPORT
SIMMESPORT FAMILY CLINIC 417 N MARTIN LUTHER KING SIMMESPORT, LA 71369(318) 941-2336
RHC RURAL HEALTH CLINIC
985 1000 AGES 0 - 64
CATAHOULA JONESVILLE CONEY WILLIAM 904 1ST STREET JONESVILLE, LA 71343(318) 339-8387
PHY FAMILY PRACTICE 247 2500 AGES 6 MONTHS - 64 YEARS
LASALLE PRIMARY HEALTHCARE CENTER
2801 4TH STREET, SUITE 5 JONESVILLE, LA 71343(318) 339-9990
RHC RURAL HEALTH CLINIC
725 3000 AGES 0 - 64
RIVERPARK MEDICAL CLINIC - JONESVILLE
800 AUDUBON DRIVE JONESVILLE, LA 71343(318) 339-4112
RHC RURAL HEALTH CLINIC
403 1000 AGES 0 - 64
SICILY ISLAND
CATAHOULA PARISH HOSPITAL 307 CHISUM STREET SICILY ISLAND, LA 71368(318) 389-5727
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
407 1000 AGES 0 - 64
CONCORDIA FERRIDAY BONOMO CARRIE 1810 EE WALLACE BLVD STE 5FERRIDAY, LA 71334(318) 757-3006
PHY PEDIATRICS 1075 2500 AGES 0 - 17
CONCORIDA COMMUNITY HEALTH CENTER
1810 EE WALLACE BLVD. FERRIDAY, LA 71334(318) 757-6969
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
256 1000 AGES 0 - 64
GREMILLION MAURICE 200 SERIO BLVD FERRIDAY, LA 71334(318) 757-2000
PHY FAMILY PRACTICE 191 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 64
LEE SARAH 100 LINCOLN AVE FERRIDAY, LA 71334(318) 757-7000
PHY FAMILY PRACTICE 400 2500 AGES 0 - 64
MOAK HUEY 112 SERIO BLVD FERRIDAY, LA 71334(318) 757-3696
PHY FAMILY PRACTICE 319 2500 CURRENT PATIENTS AGES 6 MONTHS - 64 YEARS
RIVERLAND FERRIDAY CLINIC 104 LOUISIANA AVENUE FERRIDAY, LA 71334(318) 757-0210
PHY 68 3000
VIDALIA INGRAM JOHNNY 1154 LOGAN SEWELL DRIVE VIDALIA, LA 71373(318) 336-8166
PHY FAMILY PRACTICE 193 2500 CURRENT PATIENTS AGES 0 - 20
Page Number: 58CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CONCORDIA VIDALIA PEDIATRIC & ADOLESCENT CLINIC 1806 CARTER STREET VIDALIA, LA 71373(318) 336-7172
RHC RURAL HEALTH CLINIC
1161 3000 AGES 0 - 20
GRANT COLFAX CENLA RURAL HEALTH CENTERS- CO 340 WEBB SMITH DRIVE COLFAX, LA 71417(318) 627-3700
RHC RURAL HEALTH CLINIC
683 1000 AGES 0 - 64
POLLOCK CRAIG BRUCE 3819 PATTERSON ST POLLOCK, LA 71467(318) 765-3750
PHY 681 2500 AGES 0 - 64
LA SALLE JENA CHAUDHRY RIAZ 11809 HWY 84 W JENA, LA 71342(318) 992-4133
PHY INTERNAL MEDICINE 247 2500 AGES 0 - 64
LASALLE FAMILY MEDICINE 180 NINTH STREET JENA, LA 71342(318) 992-6311
PHY 886 6000
TURNLEY IDOLPHUS 2510 NORTH FIRST ST JENA, LA 71342(318) 992-2166
PHY GENERAL PRACTICE 108 2500 AGES 0 - 64
OLLA HARDTNER MEDICAL CLINIC 1136 A N. PINE ROAD OLLA, LA 71465(318) 495-3880
RHC RURAL HEALTH CLINIC
906 6500 AGES 0 - 64
RAPIDES ALEXANDRIA CENLA CHILDRENS CLINIC & ASSOC 501 MEDICAL CTR DR\STE 100 ALEXANDRIA, LA 71301(318) 487-1358
PHY 691 6000 CURRENT PATIENTS, SIBLINGS, & NEWBORNS AGES 0 - 20
CRAIG BRUCE 2913 LEE STREET ALEXANDRIA, LA 71301(318) 445-6200
PHY 957 2500 AGES 0 - 64
FAMILY MEDICINE CENTER-ALEXANDRIA
3311 PRESCOTT ROAD SUITE 210ALEXANDRIA, LA 71302(318) 487-1477
PHY 654 3000 AGES 0 - 20
HPL FAMILY MEDICINE CLINICS 2351 VANDENBURG DR ALEXANDRIA, LA 71311(318) 473-6271
PHY 696 5000 AGES 18 - 64
HPL PEDIATRIC CLINIC 2351 VANDENBURG DRIVE ALEXANDRIA, LA 71303(318) 473-6271
PHY 2237 5000 AGES 0 - 20
Page Number: 59CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
RAPIDES ALEXANDRIA LSUMC-S FAMILY PRACTICE MEDICINE 821 ELLIOTT STREET ALEXANDRIA, LA 71301(318) 441-1030
PHY CLINIC OR OTHER GROUP PRACTICE
1694 17500 OPEN AGES 0 - 18; CURRENT PTS AGES 19 - 64
MALLORY VINCENT 3311 PRESCOTT ROAD ALEXANDRIA, LA 71301(318) 487-1717
PHY FAMILY PRACTICE 1 2500 CLOSED PANEL
MANSOOR PEDIATRIC 501 MEDICAL CTR DRIVE, STE 3A ALEXANDRIA, LA 71301(318) 484-3899
PHY CLINIC OR OTHER GROUP PRACTICE
6245 8500 AGES 0 - 20
MANUEL MICHAEL 301 4TH STREET ALEXANDRIA, LA 71301(318) 473-4632
PHY PEDIATRICS 368 500 LIMITED PANEL; CURRENT PTS & SIBLINGS AGES 0 - 16
PREMIER PEDIATRICS 3916 JACKSON STREET ALEXANDRIA, LA 71303(318) 487-9860
PHY 921 2000
PRIMARY CARE SPECIALIST 3802 PRESCOTT ROAD ALEXANDRIA, LA 71301(318) 487-6060
PHY CLINIC OR OTHER GROUP PRACTICE
65 5500 CLOSED PANEL
RAPIDES PRIMARY HEALTH CARE 1217 WILLOW GLEN RIVER RD ALEXANDRIA, LA 71302(318) 487-4400
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
2317 5000 AGES 0 - 64
RHODES PEDIATRIC CLINIC 37 CALVERT DR ALEXANDRIA, LA 71301(318) 443-9634
PHY CLINIC OR OTHER GROUP PRACTICE
160 5500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 20
SOUTHERN PEDIATRIC CLINIC 1416 METRO DRIVE ALEXANDRIA, LA 71303(318) 561-4200
PHY CLINIC OR OTHER GROUP PRACTICE
2828 5000 AGES 0 - 20
TULANE HP LONG OBSTETRICS 2351 VANDENBURG DRIVE ALEXANDRIA, LA 71303(318) 483-7122
PHY CLINIC OR OTHER GROUP PRACTICE
211 5000 FEMALES ONLY, AGES 12 - 64
BALL VERMA DEVINDER 6118-B MONROE HWY STE BBALL, LA 71405(318) 640-7366
PHY INTERNAL MEDICINE 181 2500 AGES 21 - 64
LECOMPTE RAPIDES REGIONAL PHYSICIAN GROUP 1610 WATER STREET LECOMPTE, LA 71346(318) 776-9340
PHY 898 5500
Page Number: 60CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
RAPIDES PINEVILLE CENLA CHILDRENS CLINIC & ASSOC 101 MEDICAL PARK BLVD STE APINEVILLE, LA 71360(318) 561-0252
PHY 1005 3000 CURRENT PATIENTS, SIBLINGS, & NEWBORNS AGES 0 - 20
HEALTHY STEPS PEDIATRICS 192 STILLEY RD PINEVILLE, LA 71360(318) 484-3401
RHC RURAL HEALTH CLINIC
2511 3000 AGES 0 - 17
PATEL NIRANJAN 3113 HWY 28 EAST SUITE EPINEVILLE, LA 71360(318) 767-2222
PHY PEDIATRICS 1116 2500 AGES 0 - 64
WOODWORTH
WOODWORTH FAMILY MEDICINE INC 9372 HWY 165 SOUTH WOODWORTH, LA 71485(318) 484-9588
RHC RURAL HEALTH CLINIC
968 3000 AGES 0 - 64
VERNON LEESVILLE ALAMMAR MEDICAL CLINIC PLLC 1760 S 5TH STREET LEESVILLE, LA 71446(337) 238-5700
PHY CLINIC OR OTHER GROUP PRACTICE
261 2500 AGES 0 - 64
BEG MIRZA 935 VERONE TERRACE STE BLEESVILLE, LA 71446(337) 238-6952
PHY PEDIATRICS 1275 2500 AGES 0 - 20
DEER CREEK MEDICAL CENTER 301 W. FERTITTA BLVD. LEESVILLE, LA 71446(337) 238-0167
PHY CLINIC OR OTHER GROUP PRACTICE
805 5500 AGES 0 - 21; CURRENT PATIENTS AGES 22 - 64
KHATEEB NAILA 1022 PORT ARTHUR TERRACE LEESVILLE, LA 71446(337) 238-9063
PHY PEDIATRIC ENDOCRINOLOGY, PEDIATRICS
766 2500 AGES 0 - 40
LUBBOS MEDICAL CLINIC INC 201 W. ARKANSAS STREET LEESVILLE, LA 71446(337) 239-7227
PHY CLINIC OR OTHER GROUP PRACTICE
16 5000 CLOSED PANEL
OUTPATIENT MEDICAL CENTER INC 1603 BOONE ST STE BLEESVILLE, LA 71446(337) 238-1274
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
239 2500 AGES 0 - 64
THE PEDIATRIC CENTER 802 S. 10TH STREET, SUITE C LEESVILLE, LA 71446(337) 239-2207
PHY 1050 3000
VO MEDICAL CLINIC APMC 1017 W FERTITTA BLVD LEESVILLE, LA 71446(337) 239-2606
PHY CLINIC OR OTHER GROUP PRACTICE
839 5000 AGES 0 - 64
Page Number: 61CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 6
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
VERNON ROSEPINE BYRD MEDICAL CLINIC 18570 JOHNNY B HALL RD ROSEPINE, LA 70659(337) 462-1913
PHY CLINIC OR OTHER GROUP PRACTICE
237 2500 AGES 12 - 64
WINN WINNFIELD COLLIER L .R. 301 B WEST BOUNDARY WINNFIELD, LA 71483(318) 628-2151
PHY GENERAL SURGERY 96 100 LIMITED PANEL; AGES 21 - 64
SHALOM CLINIC FOR CHILDREN 609 WEST COURT ST STE BWINNFIELD, LA 71483(318) 628-5518
RHC RURAL HEALTH CLINIC
1152 2500 AGES 0 - 20
WINN COMMUNITY HEALTH CENTER 431 W. LAFAYETTE STREET WINNFIELD, LA 71483(318) 648-0375
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
596 2000 AGES 0 - 64
MISSISSIPPI NATCHEZ NATCHEZ PEDIATRIC CLINIC 136 JEFFERSON DAVIS BLVD STE ANATCHEZ, MS 39120(601) 442-5439
PHY CLINIC OR OTHER GROUP PRACTICE
780 5000 AGES 0 - 20
STRETCH T BRIAN 55 SEARGENT S. PRENTISS STE 7NATCHEZ, MS 39120(601) 445-9543
PHY PEDIATRICS 308 2500 AGES 0 - 20
Page Number: 62CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
AVOYELLES GENERAL PRACTICE
1
INTERNAL 1
FAMILY PRACTICE 2
RHC 7
OTHER 2
TOTAL: 13 27,000 8,096
CATAHOULA RHC 2
FAMILY PRACTICE 1
FQHC 1
TOTAL: 4 7,500 1,782
CONCORDIA OTHER 1
RHC 1
FAMILY PRACTICE 4
PEDIATRICS 1
FQHC 1
TOTAL: 8 19,500 3,663
GRANT RHC 1
OTHER 1
TOTAL: 2 3,500 1,364
LA SALLE GENERAL PRACTICE
1
OTHER 1
INTERNAL 1
RHC 1
CommunityCARE Provider Summary Count By ParishREGION 6
Page Number: 63CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
LA SALLE TOTAL: 4 17,500 2,147
MISSISSIPPI OTHER 1
PEDIATRICS 1
TOTAL: 2 7,500 1,088
RAPIDES PEDIATRICS 2
FQHC 1
RHC 2
OTHER 14
FAMILY PRACTICE 1
INTERNAL 1
TOTAL: 21 98,000 26,724
VERNON FQHC 1
OTHER 6
PEDIATRICS 2
TOTAL: 9 31,000 5,488
WINN FQHC 1
RHC 1
OTHER 1
TOTAL: 3 4,600 1,844
REGION TOTALS 66 216,100 52,196
Page Number: 64CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
BIENVILLE ARCADIA BIENVILLE FAMILY CLINC - ARCADIA 1175 PINE ST STE 100ARCADIA, LA 71001(318) 263-7970
RHC RURAL HEALTH CLINIC
666 3500 AGES 0 - 64
WILLIS MEDICAL LLC 600 FACTORY OUTLET DR STE 12ARCADIA, LA 71001(318) 263-4701
PHY CLINIC OR OTHER GROUP PRACTICE
1859 2500 AGES 0 - 18
RINGGOLD CHRISTUS COUSHATTA RINGOLD RH 3342 BIENVILLE RD. RINGGOLD, LA 71068(318) 894-9137
RHC RURAL HEALTH CLINIC
619 1000 AGES 0 - 64
BOSSIER BENTON BENTON FAMILY MEDICINE LLC 188 BURT BLVD. BENTON, LA 71006(318) 965-1000
PHY CLINIC OR OTHER GROUP PRACTICE
521 3000
BOSSIER DAVID RAINES COMMUNITY HEALTH CENTER
1514 DOCTORS DR 3RD FLOORBOSSIER, LA 71111(318) 549-2500
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
2928 3000 AGES 0 - 64
WK BOSSIER PEDIATRIC PARTNERS 2300 HOSPITAL DRIVE, SUITE 120 BOSSIER, LA 71111(318) 212-7883
PHY 1244 7500
BOSSIER CITY
MANCHANDIA MANOHAR 2706 SHED ROAD BOSSIER CITY, LA 71111(318) 747-5272
PHY PEDIATRICS 2469 2500 AGES 0 - 13; BLOCKED AGES 14 - 17
HAUGHTON ACORN TO OAK PEDIATRICS 1025 HWY 80 EAST HAUGHTON, LA 71037(318) 949-0539
PHY 76 3000
PLAIN DEALING
NCMC PLAIN DEALING MEDICIAL CLINIC 108 N. LOUISIANA STREET PLAIN DEALING, LA 71064(318) 326-7272
RHC RURAL HEALTH CLINIC
873 3000 ACCEPTING AGES 0 - 18 ONLY
CADDO GILLIAM DAVID RAINES COMMUNITY HEALTH / GILLIAM
12763 LAY STREET GILLIAM, LA 71029(318) 296-4287
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
447 1000 AGES 0 - 64
OIL CITY WK OIL CITY MEDICAL CLINIC 103 SOUTH LOUISIANA HWY 1 OIL CITY, LA 71061(318) 995-6504
PHY FAMILY PRACTICE 93 2500
SHREVEPORT
CHRISTUS SCHUMPERT HOSP 1534 ELIZABETH ST, SUITE 302 SHREVEPORT, LA 71101(318) 681-7960
PHY CLINIC OR OTHER GROUP PRACTICE
1558 5000
Page Number: 65CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CADDO SHREVEPORT
CLAYTON TONYA 6821 PINES RD STE 200SHREVEPORT, LA 71129(318) 671-9309
PHY PEDIATRICS 485 500 LIMITED PANEL;CURRENT PTS & FMLY MEMBERS AGES 0-64
DAVID RAINES COMM HEALTH CENTER 1625 DAVID RAINES ROAD SHREVEPORT, LA 71107(318) 425-2252
FQHC 2391 2500 AGES 0 - 64
HARRIS LINDA 4571 NORTH MARKET SHREVEPORT, LA 71107(318) 222-4041
PHY PEDIATRICS 2240 2500 CLOSED PANEL
HATHORN-JR ALFRED 2120 BERT KOUNS STE LSHREVEPORT, LA 71118(318) 686-8197
PHY PEDIATRICS 3175 2500 MAX CAPACITY EXCEEDED; AGES 0 - 20
HENSON STEPHANIE 1801 FAIRFIELD AVE STE 201SHREVEPORT, LA 71101(318) 848-2810
PHY PEDIATRICS 1253 2500 CURRENT PATIENTS AND NEWBORNS AGES 0 - 15
HOLLIWAY BRONDWYN 3824 HEARNE AVE SHREVEPORT, LA 71103(318) 635-8606
PHY PEDIATRICS 2655 2500 AGES 0 - 20
IBRAHIM ABUBAKAR 6821 PINES RD SHREVEPORT, LA 71129(318) 686-1522
PHY FAMILY PRACTICE 2351 2500 AGES 0 - 64
LOUD SUYAH 4140 HOLLYWOOD AVE, SUITE B-Z SHREVEPORT, LA 71109(318) 946-8183
PHY PEDIATRICS 710 2500 AGES 0 - 15
LSU CHILDRENS CLINIC 1602 KINGS HWY,#110 SHREVEPORT, LA 71103(318) 675-8600
PHY 9468 12000 LIMITED PANEL; AGES 0 - 17
LSU FAMILY MEDICINE 1501 KINGS HWY SHREVEPORT, LA 71103(318) 675-5805
PHY 2849 47000 AGES 0 - 64
LSU INTERNAL MEDICINE CLINIC 1501 KINGS HWY SHREVEPORT, LA 71103(318) 813-2562
PHY 1196 20000 AGES 21 - 64
MID CITY PEDIATRICS 2225 LINE AVENUE SHREVEPORT, LA 71104(318) 221-2225
PHY CLINIC OR OTHER GROUP PRACTICE
217 17500 CLOSED PANEL
Page Number: 66CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CADDO SHREVEPORT
PEDIATRIC ASSOCIATES OF SHREVEPORT
1717 EAST BERT KOUNS SHREVEPORT, LA 71105(318) 524-1717
PHY CLINIC OR OTHER GROUP PRACTICE
1419 2000 CURRENT PATIENTS AGES 0 - 20
REGINA FAKNER MD LLC 845 OLIVE STREET, SUITE A SHREVEPORT, LA 71104(318) 226-4892
PHY CLINIC OR OTHER GROUP PRACTICE
3625 4000 AGES 0 - 18
ROUSSEAU JEAN 4140 HOLLYWOOD AVE. SHREVEPORT, LA 71109(318) 621-9600
PHY GENERAL SURGERY 2393 2500 AGES 1 - 64
SATALURI SESHA 1801 FAIRFIELD AVE #400 SHREVEPORT, LA 71101(318) 848-2830
PHY INTERNAL MEDICINE 637 2500 AGES 21 - 64
SENFF TOM 1534 ELIZABETH AVENUE SHREVEPORT, LA 71101(318) 673-8320
PHY INTERNAL MEDICINE 701 2500 AGES 21 - 64
SHREVEPORT FAMILY MED / KIDMED 7505 PINES RD STE 1250SHREVEPORT, LA 71129(318) 686-3770
PHY CLINIC OR OTHER GROUP PRACTICE
2937 3000 MAX CAPACITY EXCEEDED; AGES 0 - 64
TOGUN KIKELOMO 214 WEST 70TH ST. SUITE 104 SHREVEPORT, LA 71106(318) 869-2181
PHY PEDIATRICS 2450 2500 AGES 0 - 40
WEBB ETHAN 1801 FAIRFIELD AVE STE 210SHREVEPORT, LA 71101(318) 220-7047
PHY INTERNAL MEDICINE 6 6 CLOSED PANEL
WERNER CHARLES 1534 ELIZABETH AVENUE SHREVEPORT, LA 71101(318) 673-8320
PHY INTERNAL MEDICINE 524 2500 AGES 21 - 64
WILLIAMS MELITA 6821 PINES ROAD SUITE 400SHREVEPORT, LA 71129(318) 686-7109
PHY FAMILY PRACTICE 1618 2500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 20
WK CENTER FOR PEDIATRICS - SOUTH 2518 BERT KOUNS SHREVEPORT, LA 71118(318) 212-5437
PHY CLINIC OR OTHER GROUP PRACTICE
2253 12500 CURRENT PTS & SIBLINGS, NEWBORNS AGES 0 - 1MONTH
WK PORTICO PEDIATRICS 7847 YOUREE DRIVE SHREVEPORT, LA 71105(318) 212-3930
PHY CLINIC OR OTHER GROUP PRACTICE
1054 5000 NEWBORNS SEEN @ TIME OF BIRTH & CURRENT PTS ONLY
Page Number: 67CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CADDO SHREVEPORT
YERRAPRAGGADA SREEDEVI 1534 ELIZABETH AVENUE SHREVEPORT, LA 71101(318) 673-8320
PHY INTERNAL MEDICINE 575 2500 AGES 21 - 64
VIVAN NORTH CADDO MEDICAL CENTER 1003 S SPRUCE STREET VIVAN, LA 71082(318) 375-3239
RHC RURAL HEALTH CLINIC
2288 11000 AGES 0 - 64
CLAIBORNE HAYNESVILLE
BUTLER-ABSHIRE RURAL HEALTH CLINIC
926 FRANCES DRIVE HAYNESVILLE, LA 71038(318) 624-0554
RHC RURAL HEALTH CLINIC
279 5500 AGES 0 - 64
DAVID RAINES COMM HEALTH CENTER 1953 MAIN STREET HAYNESVILLE, LA 71038(318) 624-1995
FQHC 147 1000 AGES 0 - 64
HOMER CLAIBORNE FAMILY MEDICAL CLINIC 912 WEST MAIN HOMER, LA 71040(318) 927-3571
PHY CLINIC OR OTHER GROUP PRACTICE
635 5000 AGES 0 - 64
FAMILY MEDICAL CLINIC OF HOMER 104 MORRIS CIRCLE HOMER, LA 71040(318) 927-6777
PHY CLINIC OR OTHER GROUP PRACTICE
900 3500 AGES 0 - 64
WK CLAIBORNE REGIONAL HEALTH CENTER
104 MORRIS CIRCLE HOMER, LA 71040(318) 927-1110
RHC RURAL HEALTH CLINIC
452 3500 AGES 0 - 64
DE SOTO LOGANSPORT
DESOTO REGIONAL FAMILY MEDICINE LOGANSPORT
110 MAIN STREET LOGANSPORT, LA 71049(318) 697-2273
RHC RURAL HEALTH CLINIC
639 2500 AGES 0 - 64
MANSFIELD COMMUNITY HEALTH INSTITUTE 907 POLK STREET MANSFIELD, LA 71052(318) 872-1015
RHC 418 1000 AGES 0 - 64
DESOTO REGIONAL FAMILY MEDICINE 130 JEFFERSON STREET MANSFIELD, LA 71052(318) 872-2700
PHY CLINIC OR OTHER GROUP PRACTICE
2120 13000 AGES 0 - 64
NATCHITOCHES NATCHITOCHES
BLACK JORGE 617 BIENVILLE ST. NATCHITOCHES, LA 71457(318) 238-5040
PHY PEDIATRICS 772 2500 AGES 0 - 20
BREAZEALE ARCHIE 108 TOULINE NATCHITOCHES, LA 71457(318) 352-3804
PHY GENERAL PRACTICE 47 2500 CURRENT PATIENTS AGES 21 - 64
Page Number: 68CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
NATCHITOCHES NATCHITOCHES
CORNERSTONE PEDIATRICS 1055 PKWY DR, STE A NATCHITOCHES, LA 71457(318) 352-6464
PHY CLINIC OR OTHER GROUP PRACTICE
2862 7500 CURRENT PATIENTS AGES 0 - 17
FAIR JACK MD 615 BIENVILLE STREET NATCHITOCHES, LA 71457(318) 352-6800
PHY FAMILY PRACTICE 139 2500
HOGG JOHN 615 BIENVILLE STREET NATCHITOCHES, LA 71457(318) 352-6800
PHY FAMILY PRACTICE 298 2500 OPEN AGES 0 - 3 MONTHS; CURRENT PTS AGES 4M - 20YR
OLATINWO OLUWATOYIN 740 KEYSER AVE, SUITE F NATCHITOCHES, LA 71457(318) 238-5050
PHY INTERNAL MEDICINE 86 2500
OUTPATIENT MEDICAL CTR INC @ NATCHITOCHES
1640 BREAZEALE SPRINGS STREET NATCHITOCHES, LA 71457(318) 352-9299
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1327 7500 AGES 0 - 64
SHALOM CLINIC FOR CHILDREN AP 405 BIENVILLE STREET NATCHITOCHES, LA 71457(318) 356-7211
PHY CLINIC OR OTHER GROUP PRACTICE
1956 5000 OPEN AGES 0 - 1; BLOCKED AGES 2 - 18
RED RIVER COUSHATTA CHRISTUS COUSHATTA RURAL HEALTH CENTER
1633 MARVEL STREET COUSHATTA, LA 71019(318) 932-2222
RHC RURAL HEALTH CLINIC
368 3000 AGES 0 - 64
D GREGORY BELL MD AND WILLIS-KNIGHTON MEDICAL CENTER FAMILY PRACTICE
1633 MARVAL STREET COUSHATTA, LA 71019(318) 932-2170
PHY CLINIC OR OTHER GROUP PRACTICE
777 2500 AGES 0 - 64
HOLLOWAY ESTHER 1633 MARVEL ST COUSHATTA, LA 71019(318) 932-8937
PHY FAMILY PRACTICE 381 2500 AGES 0 - 64
WYCHE T COLEMAN JR. LLC 1633 MARVEL ST. COUSHATTA, LA 71019(318) 932-9980
PHY CLINIC OR OTHER GROUP PRACTICE
1228 3000 AGES 0 - 64
SABINE MANY HUSAM SUKEREK MD 210 HIGHLAND DRIVE MANY, LA 71449(318) 256-5722
RHC RURAL HEALTH CLINIC
1565 2500 AGES 0 - 20
SABINE MEDICAL CENTER RURAL HEALTH CLINIC #1
395 S CAPITAL MANY, LA 71449(318) 256-2000
RHC RURAL HEALTH CLINIC
1042 8000 AGES 0 - 64
Page Number: 69CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
SABINE ZWOLLE SABINE MEDICAL CENTER RURAL HEALTH CLINIC #2
1015 OBRIE ST ZWOLLE, LA 71486(318) 645-6161
RHC RURAL HEALTH CLINIC
396 2500 AGES 0 - 64
ZWOLLE RURAL CLINIC 2026 OBRIE ST ZWOLLE, LA 71486(318) 645-6013
RHC RURAL HEALTH CLINIC
306 1000 AGES 0 - 64
WEBSTER MINDEN BLAKE-MCMAHON ANDREA 129 MINDEN SHOPPING CENTER DR MINDEN, LA 71055(318) 741-8100
PHY INTERNAL MEDICINE 614 2500 AGES 0 - 64
BOLGER JOSEPH #3 MEDICAL PLAZA MINDEN, LA 71055(318) 377-7118
PHY FAMILY PRACTICE 64 200 LIMITED PANEL; AGES 0 - 20
DAVID RAINES COMM HEALTH CENTER 128 HOMER ROAD MINDEN, LA 71055(318) 377-1545
FQHC 378 1000 AGES 0 - 64
FAMILY MEDICINE ASSOCIATES 1111 HOMER ROAD MINDEN, LA 71055(318) 377-7500
RHC RURAL HEALTH CLINIC
818 3500 AGES 0 - 64
IRIZARRY FAMILY PRACTICE LLC 2 MEDICAL PLAZA MINDEN, LA 71055(318) 377-8400
PHY 523 3000
MINDEN FAMILY CARE CENTER 208 MORRIS DRIVE MINDEN, LA 71055(318) 377-8260
RHC RURAL HEALTH CLINIC
1200 6500 AGES 0 - 64
MINDEN FAMILY MEDICINE NO 3 MEDICAL PLAZA MINDEN, LA 71055(318) 377-7134
PHY CLINIC OR OTHER GROUP PRACTICE
197 200 LIMITED PANEL; AGES 0 - 20
MINDEN PEDIATRICS LLC 607 FLEMING LN MINDEN, LA 71055(318) 377-7116
PHY CLINIC OR OTHER GROUP PRACTICE
1957 4500 AGES 0 - 20
STELL FAMILY PRACTICE 102 OFFICE PARK DRIVE MINDEN, LA 71055(318) 377-2885
PHY CLINIC OR OTHER GROUP PRACTICE
551 3000 AGES 0 - 64
WAFER MARTHA 102 MONROE STREET, SUITE B MINDEN, LA 71055(318) 382-4900
PHY FAMILY PRACTICE 275 2500 AGES 0 - 64
Page Number: 70CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 7
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
WEBSTER SAREPTA NORTH WEBSTER MEDICAL CLINIC 106 TRI-STATE DRIVE SAREPTA, LA 71071(318) 994-2266
PHY CLINIC OR OTHER GROUP PRACTICE
368 1000 AGES 0 - 64
SIBLEY PHILLIPS, GREGORY & SCOTT MD 382 N MAIN ST SIBLEY, LA 71073(318) 382-9401
PHY FAMILY PRACTICE 366 2500 AGES 0 - 64; ACCEPTS NEW PTS AGES 0 - 17 ONLY
SPRINGHILL SMC/DOCTORS CLINIC 401 11TH N.E. SPRINGHILL, LA 71075(318) 539-1700
RHC RURAL HEALTH CLINIC
1198 13000 AGES 0 - 64
Page Number: 71CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
BIENVILLE OTHER 1
RHC 2
TOTAL: 3 7,000 3,144
BOSSIER RHC 1
OTHER 3
FQHC 1
PEDIATRICS 1
TOTAL: 6 22,000 8,111
CADDO OTHER 12
PEDIATRICS 7
FQHC 1
RHC 1
FAMILY PRACTICE 3
INTERNAL 5
TOTAL: 29 178,006 53,568
CLAIBORNE RHC 2
OTHER 3
TOTAL: 5 18,500 2,413
DE SOTO RHC 2
OTHER 1
TOTAL: 3 16,500 3,177
NATCHITOCHES GENERAL PRACTICE
1
PEDIATRICS 1
INTERNAL 1
CommunityCARE Provider Summary Count By ParishREGION 7
Page Number: 72CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
NATCHITOCHES FQHC 1
OTHER 2
FAMILY PRACTICE 2
TOTAL: 8 32,500 7,487
RED RIVER OTHER 2
FAMILY PRACTICE 1
RHC 1
TOTAL: 4 11,000 2,754
SABINE RHC 4
TOTAL: 4 14,000 3,309
WEBSTER OTHER 6
FAMILY PRACTICE 3
RHC 3
INTERNAL 1
TOTAL: 13 43,400 8,509
REGION TOTALS 75 342,906 92,472
Page Number: 73CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
CALDWELL COLUMBIA CITIZENS RURAL CLINIC 484 COLLINS ROAD, SUITE A COLUMBIA, LA 71418(318) 649-5300
RHC RURAL HEALTH CLINIC
1236 9000 AGES 0 - 64
SHROFF PANKAJRAI 7937 US HIGHWAY 165 COLUMBIA, LA 71418(318) 649-2621
PHY INTERNAL MEDICINE 14 2500 CURRENT PATIENTS AGES 21 - 64
WINTERS CLINIC 421 MAIN STREET COLUMBIA, LA 71418(318) 649-6157
RHC RURAL HEALTH CLINIC
753 5500 AGES 0 - 64
EAST CARROLL LAKE PROVIDENCE
FAMILY MEDICAL CLINIC 300 SCARBOROUGH STREET LAKE PROVIDENCE, LA 71254(318) 559-2814
RHC RURAL HEALTH CLINIC
567 3000 AGES 0 - 64
LAKE PROVIDENCE MEDICAL CLINIC 319 NORTH HOOD STREET LAKE PROVIDENCE, LA 71254(318) 559-1221
RHC RURAL HEALTH CLINIC
642 5500 AGES 0 - 64
THE FAMILY PRACTICE CLINIC 320 NORTH HOOD STREET LAKE PROVIDENCE, LA 71254(318) 559-2404
RHC RURAL HEALTH CLINIC
1625 7000 AGES 0 - 64
FRANKLIN WINNSBORO COLVIN MEDICAL CORPORATION 2106-A LOOP RD WINNSBORO, LA 71295(318) 435-8020
PHY CLINIC OR OTHER GROUP PRACTICE
1050 3000 AGES 0 - 64
COUGHRAN MEDICAL CORPORATION 2106-A LOOP ROAD WINNSBORO, LA 71295(318) 435-8020
PHY 904 3500 AGES 0 - 64
FRANKLIN MEDICAL CENTER RHC WINNSBORO
2104 C LOOP ROAD WINNSBORO, LA 71295(318) 435-4571
RHC RURAL HEALTH CLINIC
773 3500 AGES 0 - 64
WINNSBORO MEDICAL CLINIC 3326 FRONT ST STE BWINNSBORO, LA 71295(318) 435-7333
PHY CLINIC OR OTHER GROUP PRACTICE
1230 4500 AGES 0 - 64
WISNER WISNER MEDICAL CLINIC 126 WATSON STREET WISNER, LA 71378(318) 724-7008
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
307 3000 AGES 0 - 64
WISNER RURAL HEALTH CLINIC 176 WATSON WISNER, LA 71378(318) 724-6789
RHC RURAL HEALTH CLINIC
364 1000 AGES 0 - 64
Page Number: 74CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
JACKSON CHATHAM CHATHAM MEDICAL CLINIC 804 CHATHAM AVENUE CHATHAM, LA 71251(318) 249-3200
PHY CLINIC OR OTHER GROUP PRACTICE
136 1000 AGES 0 - 64
JONESBORO AGARWAL KUSHAL 510 ALEXANDER STREET JONESBORO, LA 71251(318) 259-2148
PHY 277 2500 AGES 7 MONTHS - 64 YEARS
CROUCH REBECCA 166 BEECH SPRINGS JONESBORO, LA 71251(318) 259-3668
PHY GENERAL SURGERY 241 2500 AGES 1 - 64
JONESBORO FAMILY CARE CLINIC 121 WATTS STREET, STE A,B,E&F JONESBORO, LA 71251(318) 259-5636
RHC RURAL HEALTH CLINIC
486 6000 AGES 0 - 64
JONSEBORO JACKSON PARISH HOSPITAL FAMILY CARE CLINIC
107 WATTS STREET JONSEBORO, LA 71251(318) 395-2121
RHC RURAL HEALTH CLINIC
1184 2500 AGES 0 - 64
LINCOLN RUSTON AGARWAL KUSHAL 411 EAST VAUGHN, SUITE 102 RUSTON, LA 71270(318) 232-0019
PHY 257 2500 AGES 7 MONTHS - 64 YEARS
BELUE JAMES 411 EAST VAUGHN, STE 105 RUSTON, LA 71270(318) 251-3774
PHY FAMILY PRACTICE 1572 2500 AGES 0 - 64
CONVILLE STACY 1809 NORTH POINTE LN, STE 102 RUSTON, LA 71270(318) 251-8232
PHY FAMILY PRACTICE 347 2500 AGES 0 - 64
FAMILY FIRST MEDICINE APMC 1503 GOODWIN RD STE 207RUSTON, LA 71270(318) 513-1950
RHC RURAL HEALTH CLINIC
879 2500 AGES 0 - 64
GREEN CLINIC LLC 1200 S. FARMERVILLE ST. RUSTON, LA 71270(318) 255-3690
PHY 1576 10000 CURRENT PATIENTS AGES 0 - 18
GREEN CLINIC LLC 1200 SOUTH FARMERVILLE RUSTON, LA 71270(318) 255-3690
PHY 9 20 CLOSED PANEL
GREEN CLINIC LLC 1402 CELEBRITY DRIVE RUSTON, LA 71270(318) 255-1515
PHY 438 7500 LIMITED PANEL; AGES 0 - 18; CLOSED AGES 19 - 64
Page Number: 75CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LINCOLN RUSTON GREEN CLINIC LLC 1200 S. FARMERVILLE STREET RUSTON, LA 71270(318) 255-3690
PHY 39 40 LIMITED PANEL; AGES 21 - 64
GREEN CLINIC LLC 1200 S. FARMERVILLE STREET RUSTON, LA 71270(318) 255-3690
PHY 38 40 LIMITED PANEL; AGES 21 - 64
HERBERT ALLEN 411 EAST VAUGHN, STE 203 RUSTON, LA 71270(318) 255-7474
PHY GENERAL PRACTICE 260 2500 CURRENT PATIENTS AGES 0 - 64
MCINTYRE BRENDA 206 E REYNOLDS DR., SUITE C #3 RUSTON, LA 71270(318) 255-4112
PHY PEDIATRICS 904 2500 AGES 0 - 17
MADISON TALLULAH BROWN EVERETT 10 CROTHERS DRIVE SUITE 4TALLULAH, LA 71282(318) 574-2764
PHY PEDIATRICS 376 2500 AGES 0 - 64
CHENIER LAWRENCE 1000 JOHNSON ST TALLULAH, LA 71282(318) 574-5974
PHY GENERAL PRACTICE 597 2500 AGES 0 - 64
MADISON PARISH HOSPITAL RURAL 212 S. CHESTNUT STREET TALLULAH, LA 71282(318) 574-3575
RHC 1225 3000
OUTPATIENT MEDICAL CENTER INC 804 BEECH STREET TALLULAH, LA 71282(318) 574-1453
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
868 5000 AGES 0 - 64
MOREHOUSE BASTROP COATS V JOHN 327 WEST HICKORY AVE BASTROP, LA 71220(318) 556-3071
PHY FAMILY PRACTICE 291 900 LIMITED PANEL; AGES 6 - 64
FAMILY MEDICAL CENTER 540 DURHAM STREET BASTROP, LA 71220(318) 283-2200
PHY 425 2500 AGES 0 - 64
MOREHOUSE COMMUNITY MEDICAL CENTER
518 DURHAM STREET BASTROP, LA 71220(318) 283-8887
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1758 3500 AGES 0 - 64
MOREHOUSE GENERAL HOSPITAL 420 S VINE STREET BASTROP, LA 71220(318) 283-3032
PHY 21 2500
Page Number: 76CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
MOREHOUSE BASTROP NOBLE JACK 355 W HICKORY STREET BASTROP, LA 71220(318) 281-4450
PHY FAMILY PRACTICE 13 2500 CURRENT PATIENTS AGES 21 - 64
TRAN ANDY 365 WEST HICKORY BASTROP, LA 71220(318) 283-5999
PHY FAMILY PRACTICE 422 2500
TREJO DANIEL 511 GUNBY AVENUE BASTROP, LA 71220(318) 281-2410
PHY FAMILY PRACTICE 905 2500 CURRENT PATIENTS AND NEWBORNS AGES 0 - 64
MER ROUGE ALLEN L SPIRES MD APMC 301 DAVENPORT AVE MER ROUGE, LA 71261(318) 647-5008
PHY CLINIC OR OTHER GROUP PRACTICE
1773 3000 AGES 0 - 64
FAMILY MEDICAL CLINIC OF MER ROUGE
205 SOUTH DAVENPORT AVE. MER ROUGE, LA 71261(318) 647-3720
PHY CLINIC OR OTHER GROUP PRACTICE
1203 3000 AGES 0 - 64
MOREHOUSE COMMUNITY MEDICAL CENTER
108 N 16TH STREET MER ROUGE, LA 71261(318) 239-8010
FQHC 28 1000
OUACHITA CALHOUN NISHAT ARIFA 3057 HWY 80 WEST CALHOUN, LA 71225(318) 644-4412
PHY FAMILY PRACTICE, LSU MEDICAL CENTER SHREVEPORT
66 2500
MONROE ACHILIHU GODFREY 614 N 2ND ST MONROE, LA 71201(318) 330-9330
PHY CARDIOVASCULAR DISEASE, INTERNAL MEDICINE
99 2500 AGES 21 - 64
BATTLES CAROLINE 2221 JUSTICE MONROE, LA 71201(318) 329-3395
PHY FAMILY PRACTICE 9 2500 CURRENT PATIENTS AGES 0 - 64
FAMILY MEDICAL CENTER 3510 MEDICAL PARK DR SUITE 8MONROE, LA 71203(318) 325-3332
PHY 1329 2500 AGES 0 - 64
INTERNAL MEDICINE OF THE TWIN CITIES
3510 MEDICAL PARK DR STE 9MONROE, LA 71203(318) 388-6050
PHY CLINIC OR OTHER GROUP PRACTICE
91 5000 CURRENT PATIENTS AGES 21 - 64
KIDHEALTH LLC 5000 FORSYTHE BYPASS SUITE 2MONROE, LA 71201(318) 812-0168
PHY CLINIC OR OTHER GROUP PRACTICE
749 2500 AGES 0 - 20
Page Number: 77CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
OUACHITA MONROE LAPITE OLADAPO 306 STONE AVENUE MONROE, LA 71202(318) 323-1040
PHY FAMILY PRACTICE 915 2500 AGES 0 - 35
LSU-MONROE\EA CONWAY-ADULT CLINIC
4864 JACKSON STREET MONROE, LA 71202(318) 330-7167
PHY 484 15500 AGES 13 - 64
LSU-MONROE\EA CONWAY-FAMILY 4864 JACKSON ST. MONROE, LA 71202(318) 330-7600
PHY 1248 10000 AGES 0 - 64
LSU-MONROE\EA CONWAY-PEDIACTRIC 4864 JACKSON STREET MONROE, LA 71202(318) 330-7169
PHY 1048 5500 AGES 0 - 12
NORTHEAST RURAL HEALTH 2101 TOWER DRIVE MONROE, LA 71201(318) 387-4878
PHY 2180 3000 AGES 0 - 64
PATTERSON JAMES 1511 ORANGE STREET MONROE, LA 71202(318) 322-7798
PHY FAMILY PRACTICE 553 2500 AGES 3 - 64
PEDIATRICS PLUS AMC 3401 MAGNOLIA COVE MONROE, LA 71203(318) 325-6311
PHY CLINIC OR OTHER GROUP PRACTICE
330 5500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 15
PRIMARY HEALTH SERVICES CENTER 850 SOUTH SECOND STREET MONROE, LA 71202(318) 651-0041
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1091 3500 AGES 0 - 64
PRIMARY HEALTH SERVICES CENTER 2913 DESIARD STREET MONROE, LA 71202(318) 651-9914
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
2592 7500 AGES 0 - 64
PROGRESSIVE PEDIATRICS 3116 KILPATRICK BLVD MONROE, LA 71201(318) 410-9898
PHY CLINIC OR OTHER GROUP PRACTICE
338 400 LIMITED PANEL; CURRENT PTS AGES 0 - 20
RANDY W HEAD MD APMC 600 GRAMMONT STREET MONROE, LA 71201(318) 387-3888
PHY CLINIC OR OTHER GROUP PRACTICE
2629 3000 MAX CAPACITY EXCEEDED; AGES 0 - 64
SOLE CARE LLC 2803 EVANGELINE ST MONROE, LA 71201(318) 325-0325
PHY CLINIC OR OTHER GROUP PRACTICE
522 3000 AGES 0 - 64
Page Number: 78CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
OUACHITA MONROE ST FRANCIS CONVENIENCE CLINIC 920 OLIVER RD., STE. 1600 MONROE, LA 71201(318) 327-6220
PHY CLINIC OR OTHER GROUP PRACTICE
2957 5000 AGES 0 - 64
ST FRANCIS HEALTHY KIDS CLINIC 3510 MEDICAL PARK DR, SUITE 3 MONROE, LA 71203(318) 966-6165
PHY CLINIC OR OTHER GROUP PRACTICE
2472 9000 AGES 0 - 20
STERLINGTON HEALTH CLINIC 1470 GARRETT ROAD MONROE, LA 71202(318) 387-2981
PHY 630 3000
WALTERS KERMIT 1910 JACKSON STREET MONROE, LA 71202(318) 325-7998
PHY FAMILY PRACTICE 1475 2500 AGES 0 - 64
WILLIAMS THOMAS 516 LINCOLN ROAD MONROE, LA 71203(318) 343-6487
PHY FAMILY PRACTICE 46 2500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 64
STERLINGTON
STERLINGTON CLINIC 115 LA HWY 2 STERLINGTON, LA 71280(318) 665-4543
RHC RURAL HEALTH CLINIC
504 3000 AGES 0 - 64
STERLINGTON HEALTH CLINIC 10374 HWY 165 N, SUITE D STERLINGTON, LA 71280(318) 812-2304
PHY CLINIC OR OTHER GROUP PRACTICE
878 3500 AGES 0 - 64
WEST MONROE
ALL KIDS R US MEDICAL CLINIC 107 CONTEMPO SUITE BWEST MONROE, LA 71291(318) 388-5030
PHY CLINIC OR OTHER GROUP PRACTICE
3204 5500 AGES 0 - 20; ACCEPTING AGES 0 - 16 ONLY
FIGUEROA GLEN 206 MCMILLAN ROAD, SUITE 1 WEST MONROE, LA 71291(318) 855-4062
PHY PHYSICAL MEDICINE REHABILITATION
249 2500 AGES 21 - 64
ROSALES CHILDRENS CLINIC 104 CONTEMPO AVENUE WEST MONROE, LA 71291(318) 807-1360
PHY CLINIC OR OTHER GROUP PRACTICE
657 3000 OPEN AGES 0 - 1M; CURRENT PTS AGES 2M - 16 YRS
SANSON FAMILY MEDICINE 2309 ARKANSAS ROAD WEST MONROE, LA 71291(318) 397-7000
PHY CLINIC OR OTHER GROUP PRACTICE
926 3500 AGES 0 - 64
RICHLAND DELHI DELHI RURAL HEALTH CLINIC 508 BROADWAY DELHI, LA 71232(318) 878-3737
RHC RURAL HEALTH CLINIC
1522 15500 AGES 0 - 64
Page Number: 79CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
RICHLAND MANGHAM RALPH L ABRAHAM MD APMC 261 HIGHWAY 132 MANGHAM, LA 71259(318) 248-2807
PHY CLINIC OR OTHER GROUP PRACTICE
1354 4000 AGES 0 - 64
RONALD J MORGAN APMC 107 LELA STREET MANGHAM, LA 71259(318) 248-2165
PHY CLINIC OR OTHER GROUP PRACTICE
221 3000 AGES 0 - 64
RAYVILLE KERR ALBERT 121 CHRISTIAN DRIVE RAYVILLE, LA 71269(318) 728-0175
PHY FAMILY PRACTICE 361 2500 AGES 0 - 64
NORTHEAST LA HEALTH CENTER 1012 SOUTH LOUISA STREET RAYVILLE, LA 71269(318) 728-2046
RHC RURAL HEALTH CLINIC
913 10500 AGES 0 - 64
RAYVILLE FAMILY CLINIC 1962 JULIA STREET RAYVILLE, LA 71269(318) 728-8833
PHY CLINIC OR OTHER GROUP PRACTICE
1383 3500 AGES 0 - 64
START COMMUNITY CLINIC 5975 FEDERAL HWY 80 RAYVILLE, LA 71269(318) 728-4368
RHC RURAL HEALTH CLINIC
393 2000 AGES 0 - 64
TENSAS NEWELLTON FRANKLIN MEDICAL CENTER RHC 104 VERONA STREET NEWELLTON, LA 71357(318) 467-9949
RHC RURAL HEALTH CLINIC
495 1000 AGES 0 - 64
ST. JOSEPH FRANKLIN MEDICAL CENTER RHC ST JOSEPH
448 NEWTON STREET ST. JOSEPH, LA 71366(318) 766-8506
RHC RURAL HEALTH CLINIC
340 1000 AGES 0 - 64
TENSAS COMMUNITY HEALTH CENTER 1115 LEVEE STREET ST. JOSEPH, LA 71366(318) 766-1967
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
133 1000 AGES 0 - 64
UNION BERNICE TRI WARD CLINIC 402 SECOND STREET BERNICE, LA 71222(318) 285-9066
RHC RURAL HEALTH CLINIC
919 5500 AGES 0 - 64
FARMERVILLE
UNION GENERAL RURAL HEALTH CLINIC
1025 MARION HIGHWAY FARMERVILLE, LA 71241(318) 368-9745
RHC RURAL HEALTH CLINIC
1135 3000 AGES 0 - 64
UNKEL STEVEN 811 JAMES AVENUE FARMERVILLE, LA 71241(318) 368-2238
PHY FAMILY PRACTICE 771 2500 AGES 0 - 64
Page Number: 80CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 8
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
UNION FARMERVILLE
VENTERS STEVEN 811 JAMES AVE,STE B FARMERVILLE, LA 71241(318) 368-0190
PHY INTERNAL MEDICINE 740 2500 UNION PARISH RESIDENTS ONLY AGES 0 - 20
MARION UNION CLINIC OF MARION 3150 TAYLOR STREET MARION, LA 71260(318) 292-2795
RHC RURAL HEALTH CLINIC
153 1000 AGES 0 - 64
WEST CARROLL OAK GROVE COMMUNITY MEDICAL CLINIC 712 SETTOON OAK GROVE, LA 71263(318) 428-2341
RHC RURAL HEALTH CLINIC
361 3000 AGES 0 - 64
OAK GROVE MEDICAL CLINIC 708 E. MAIN OAK GROVE, LA 71263(318) 428-3200
RHC RURAL HEALTH CLINIC
683 5500 AGES 0 - 64
WEST CARROLL MEDICAL CLINIC 502 ROSS STREET OAK GROVE, LA 71263(318) 428-2358
RHC RURAL HEALTH CLINIC
661 5500 AGES 0 - 64
Page Number: 81CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
CALDWELL INTERNAL 1
RHC 2
TOTAL: 3 17,000 2,003
EAST CARROLL RHC 3
TOTAL: 3 15,500 2,834
FRANKLIN OTHER 3
RHC 2
FQHC 1
TOTAL: 6 18,500 4,628
JACKSON RHC 2
OTHER 3
TOTAL: 5 14,500 2,324
LINCOLN GENERAL PRACTICE
1
FAMILY PRACTICE 2
PEDIATRICS 1
OTHER 6
RHC 1
TOTAL: 11 32,600 6,319
MADISON OTHER 1
GENERAL PRACTICE
1
PEDIATRICS 1
FQHC 1
TOTAL: 4 13,000 3,066
CommunityCARE Provider Summary Count By ParishREGION 8
Page Number: 82CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
MOREHOUSE FAMILY PRACTICE 4
OTHER 5
FQHC 1
TOTAL: 10 23,900 6,839
OUACHITA FAMILY PRACTICE 6
RHC 1
FQHC 2
OTHER 19
INTERNAL 1
TOTAL: 29 122,400 30,271
RICHLAND FAMILY PRACTICE 1
OTHER 3
RHC 3
TOTAL: 7 41,000 6,147
TENSAS FQHC 1
RHC 2
TOTAL: 3 3,000 968
UNION INTERNAL 1
RHC 3
FAMILY PRACTICE 1
TOTAL: 5 14,500 3,718
WEST CARROLL RHC 3
TOTAL: 3 14,000 1,705
REGION TOTALS 89 329,900 70,822
Page Number: 83CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LIVINGSTON ALBANY ALBANY MEDICAL CLINIC 29565 S MONTPELIER ROAD ALBANY, LA 70711(225) 209-0850
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
472 9500 AGES 0 - 64
DENHAM SPRINGS
ASBAHI M 303 VETERANS BLVD STE CDENHAM SPRINGS, LA 70726(225) 664-8010
PHY ADOLESCENT MEDICINE, PEDIATRICS
1481 2500 AGES 0 - 17
LPCP PEDIATRICS @ DENHAM SPRINGS 311 VETERANS BLVD.,SUITE B DENHAM SPRINGS, LA 70726(225) 665-4554
PHY 2452 11000 NEWBORNS, CURRENT PATIENTS & SIBLINGS AGES 0 - 64
LPCP PRIMARY CARE OF LIVE OAK 31995 LA HWY 16 DENHAM SPRINGS, LA 70726(225) 214-4200
PHY 17 5000
MASS JOSEPH 303 VETERANS BLVD STE ADENHAM SPRINGS, LA 70726(225) 665-7785
PHY FAMILY PRACTICE 43 2500 CURRENT PATIENTS AGES 4 - 64
OCHSNER CLINIC OF DENHAM SPRINGS
30819 LA HWY 16 DENHAM SPRINGS, LA 70726(225) 664-2029
PHY CLINIC OR OTHER GROUP PRACTICE
97 7500 CURRENT PATIENTS & SIBLINGS AGES 0 - 64
PEDICONS INC DBA KIDMED EAST 8369 FLORIDA BLVD. #2 DENHAM SPRINGS, LA 70726(225) 667-2777
PHY 2550 2500 AGES 0 - 20
TRIPURANENI JANNAIAH 230 VETERANS BLVD SUITE ADENHAM SPRINGS, LA 70726(225) 667-5454
PHY INTERNAL MEDICINE 920 2500 OPEN AGES 2 - 17 & 56 - 64; CURR PTS AGES 18 - 55
YOUNG-JR HENRY 1286 DEL ESTE AVENUE DENHAM SPRINGS, LA 70726(225) 667-3100
PHY FAMILY PRACTICE 244 2500 CLOSED PANEL
ZGANJAR BRIAN 1211 N RANGE STE DDENHAM SPRINGS, LA 70726(225) 665-6677
PHY PEDIATRICS 2102 2500 CURRENT PATIENTS AND SIBLINGS AGES 0 - 20
LIVINGSTON BATON ROUGE FAMILY MEDICINE CENTER
13960 FLORIDA BLVD LIVINGSTON, LA 70754(225) 686-0158
PHY CLINIC OR OTHER GROUP PRACTICE
105 3000 CURRENT PATIENTS AGES 7 - 64
STEWART FAMILY MEDICINE & AFT 14292 FLORIDA BLVD. LIVINGSTON, LA 70754(225) 686-1114
RHC 444 1000
Page Number: 84CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
LIVINGSTON MAUREPAS RIVERSIDE FAMILY MEDICINE LLC 12489 HOME PORT DR STE DMAUREPAS, LA 70449(225) 698-3435
RHC RURAL HEALTH CLINIC
361 1000 AGES 0 - 64
ST. HELENA DENHAM SPRINGS
FAMILY HEALTH OF ST HELENA LLC 51991 HWY 16 DENHAM SPRINGS, LA 70706(225) 791-3092
RHC RURAL HEALTH CLINIC
1267 4500 AGES 6 MONTHS - 64 YEARS
GREENSBURG
JIMMIE W VARNADO 6214 HWY 10 GREENSBURG, LA 70441(225) 222-3206
PHY CLINIC OR OTHER GROUP PRACTICE
954 6000 AGES 0 - 64
ST. HELENA COMMUNITY HEALTH CENTER
490 SITMAN STREET GREENSBURG, LA 70441(225) 222-6059
FQHC 331 2000 AGES 0 - 64
ST. TAMMANY CONVINGTON
WHITE ELIZABETH 205 HIGHLAND PARK PLAZA CONVINGTON, LA 70433(985) 871-8681
PHY PEDIATRICS 104 2500 CURRENT PATIENTS AGES 0 - 18
COVINGTON CHILDREN'S HOSPITAL MEDICAL PRACTICE CO
728 11TH AVE. COVINGTON, LA 70433(985) 893-3395
PHY 556 10000 CURRENT PATIENTS AGES 0 - 17
CHILDREN'S MEDICAL CENTER 71107 HIGHWAY 21, STE 1 COVINGTON, LA 70433(985) 893-2580
PHY CLINIC OR OTHER GROUP PRACTICE
3932 8500 AGES 0 - 18
DR BRUCE S SAMUELS LLC 207 HIGHLAND PARK PLAZA COVINGTON, LA 70433(985) 871-8920
PHY CLINIC OR OTHER GROUP PRACTICE
1795 5000 AGES 21 - 64
LEVI TANIA 1980 N. HWY 190 COVINGTON, LA 70433(985) 809-6195
PHY INTERNAL MEDICINE 3 2500 CURRENT PATIENTS AGES 21 - 64
OCHSNER CLINIC MANDEVILLE 101 E FAIRWAY APPROACH STE 302COVINGTON, LA 70433(985) 809-5800
PHY 1099 12500 AGES 0 - 20; ACCEPTS CURRENT PTS AGES 0 - 18 ONLY
PONTCHARTRAIN PEDIATRICS LLC 4405 HWY 190 SERVICE ROAD COVINGTON, LA 70433(985) 893-8505
PHY CLINIC OR OTHER GROUP PRACTICE
6140 15000 AGES 0 - 18
PUROHIT SURENDA MD 71207 HIGHWAY 21 COVINGTON, LA 70433(985) 892-6811
PHY GENERAL SURGERY 50 2500 CURRENT PATIENTS AGES 21 - 64
Page Number: 85CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. TAMMANY COVINGTON ROBINSON JAMES 180 GREENBRIAR BLVD COVINGTON, LA 70433(985) 809-7171
PHY INTERNAL MEDICINE 5 2500 CURRENT PATIENTS AGES 21 - 64
ST TAMMANY PHYSICIANS NETWORK 80 GARDENIA DRIVE SUITE B COVINGTON, LA 70433(985) 871-5900
PHY 42 10000 CURRENT PATIENTS AGES 21 - 64
STARKE ULRICH 102 HIGHLAND PARK PLAZA COVINGTON, LA 70433(985) 893-6558
PHY INTERNAL MEDICINE 5 2500 CURRENT PATIENTS AGES 21 - 64
LACOMBE CHILDREN'S INTERNATIONAL 27350 HWY 190 WEST LACOMBE, LA 70445(985) 882-7077
PHY 802 3000 AGES 0 - 17
MANDEVILLE CAPONE KEITH 1200 W CAUSEWAY APPROACH STE21MANDEVILLE, LA 70471(985) 674-9331
PHY 17 2500 CLOSED PANEL
DEVOE TIN TIN 4880 HWY 22 MANDEVILLE, LA 70471(985) 845-8894
PHY PEDIATRICS 1225 2500 OPEN AGES 0 - 18; BLOCKED AGES 19 - 20
GARAUDY ANDREA 1200 W CAUSEWAY APPROACH STE21MANDEVILLE, LA 70471(985) 674-9331
PHY 20 2500 CLOSED PANEL
ST TAMMANY PHYSICIANS NETWORK 201 ST. ANN STREET SUITE B MANDEVILLE, LA 70471(985) 626-1717
PHY 773 12500 AGES 0 - 17; CURRENT PATIENTS AGES 18 - 64
YOUSEF MOHAMMED 4430 HWY 22 MANDEVILLE, LA 70471(985) 626-3470
PHY FAMILY PRACTICE 233 250 LIMITED PANEL; AGES 6 - 30; CURRENT PTS 31 - 64
SLIDELL CHILDRENS INTERNATIONAL 1430 LINDBERG DR SLIDELL, LA 70458(985) 781-7337
PHY 2955 3000 AGES 0 - 17
DECLOUET ALETA 659 BROWNSWITCH ROAD SLIDELL, LA 70458(985) 781-7577
PHY INTERNAL MEDICINE 992 2500 CURRENT PATIENTS AGES 21 - 64
DUTHU ANGELA 3020 E. GAUSE BLVD SLIDELL, LA 70461(985) 726-0800
PHY PEDIATRICS 681 2500 CURRENT PATIENTS & SIBLINGS AGES 0 - 18
Page Number: 86CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
ST. TAMMANY SLIDELL HELEN E STEVENSON MD 310 B GATEWAY DRIVE SLIDELL, LA 70461(985) 645-8687
PHY CLINIC OR OTHER GROUP PRACTICE
2853 7500 AGES 0 - 20
LARCENA ALLAN 105 MEDICAL CENTER DR. STE 301SLIDELL, LA 70461(985) 646-0123
PHY INTERNAL MEDICINE 1025 2500 CURRENT PATIENTS AGES 14 - 64
OCHSNER CHILDREN'S HEALTH CENTER
2370 GAUZE BLVD. SLIDELL, LA 70461(985) 639-3755
PHY 1554 1800 LIMITED PANEL; AGES 0 - 18
RAINA SANJAY 1051 GAUSE BLVD STE 400SLIDELL, LA 70458(985) 641-6882
PHY INTERNAL MEDICINE 25 2500 CURRENT PATIENTS AGES 21 - 64
ROHEIM JOHN G M 105 MEDICAL CENTER DR,STE 202A SLIDELL, LA 70461(985) 645-8996
PHY PEDIATRICS 1816 2500 AGES 0 - 20
ROWLAND SHERYL 1400 HWY 190 W SLIDELL, LA 70460(985) 646-1226
PHY PEDIATRICS 256 2500 CURRENT PATIENTS AGES 0 - 17
ST TAMMANY COMMUNITY HEALTH CLINIC
1340 14TH STREET SLIDELL, LA 70458(985) 649-8775
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
2000 3000 AGES 0 - 20
TANGIPAHOA AMITE AMITE RURAL HEALTH CLINIC 309 WEST WALNUT STREET AMITE, LA 70422(985) 748-7141
RHC RURAL HEALTH CLINIC
975 1000 AGES 13 MONTHS - 64 YEARS
BIGGS MAUREEN 309 WEST WALNUT ST., SUITE A AMITE, LA 70422(985) 748-9812
NP FAMILY PRACTICE 286 1000 CLOSED PANEL
CEFALU JR. NICHOLAS M 112 EAST CHESTNUT ST. AMITE, LA 70422(985) 748-3272
PHY FAMILY PRACTICE 290 2500 AGES 21 - 64
GOLDSBY REGINALD 309 WALNUT ST STE FAMITE, LA 70422(985) 247-2700
PHY FAMILY PRACTICE 12 2500
MAUTERER ARTHUR MD 309 WALNUT ST STE BAMITE, LA 70422(985) 748-5004
PHY INTERNAL MEDICINE 129 2500 CURRENT PATIENTS AND FAMILY MEMBERS AGES 14 - 64
Page Number: 87CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
TANGIPAHOA AMITE RAY DERRIS 309 WALNUT ST SUITE D AMITE, LA 70422(985) 748-5158
PHY FAMILY PRACTICE 432 2500 CURRENT PATIENTS AGES 13 MONTHS - 64 YEARS
SHAHID MUHAMMAD 409 N.W. CENTRAL AVE, SUITE B AMITE, LA 70422(985) 747-0444
PHY INTERNAL MEDICINE 430 2500 CLOSED PANEL
HAMMOND CHILDREN FIRST KIDMED 1828 W THOMAS ST HAMMOND, LA 70401(985) 419-2250
RHC RURAL HEALTH CLINIC
628 2000 AGES 0 - 20
CHILDREN'S INTERNATIONAL 42124 VETERANS AVE., SUITE A HAMMOND, LA 70403(985) 543-0565
PHY 1754 3000 AGES 0 - 17
LOBUE ANGELO 15800 PROFESSIONAL PLAZA HAMMOND, LA 70403(985) 345-2180
PHY PEDIATRICS 807 2500 AGES 0 - 12
MURRAY-JR WINSTON 109 WEST MINNESOTA PARK HAMMOND, LA 70403(985) 542-5800
PHY INTERNAL MEDICINE 1388 2500 AGES 0 - 64
NORTH OAKS PEDIATRIC CLINIC 15756 MEDICAL ARTS PLAZA HAMMOND, LA 70403(985) 318-6599
PHY 2530 7000 AGES 0 - 21
NORTH OAKS PEDIATRIC KIDMED CLINIC
15695 PROFESSIONAL PLAZA HAMMOND, LA 70403(985) 542-2599
PHY 8061 12000 AGES 0 - 20
NORTH OAKS PEDIATRIC KIDMED CLINIC
15760 MEDICAL ARTS PLAZA HAMMOND, LA 70403(985) 542-8599
PHY 2990 9000 AGES 0 - 20
NORTH OAKS SPECIALITY CLINIC 1902 S MORRISON BLVD HAMMOND, LA 70403(985) 230-5800
PHY 381 10500 CURRENT PATIENTS & FUTURE SIBLINGS AGES 1 - 64
OVERTON JOHN 16031 DEBLIN SQ., HWY 51 SOUTH HAMMOND, LA 70403(985) 386-9911
PHY PEDIATRICS 711 2500 AGES 0 - 20
INDEPENDENCE
GENOVESE-JR CHARLES 312 E RAILROAD AVE INDEPENDENCE, LA 70443(985) 878-4183
PHY INTERNAL MEDICINE 674 2500 AGES 21 - 64
Page Number: 88CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
TANGIPAHOA INDEPENDENCE
LALLIE KEMP HOSPITAL CLINICS 52579 HIGHWAY 51 SOUTH INDEPENDENCE, LA 70443(985) 878-1500
PHY CLINIC OR OTHER GROUP PRACTICE
2078 19500 AGES 2 MONTHS - 64 YEARS
MULTIPRACTICE CLINIC 281 W. 4TH STREET INDEPENDENCE, LA 70443(985) 878-0066
FQHC FEDERALLY QUALIFIED HEALTH CENTERS
1990 4000 AGES 0 - 64
NORTH OAKS SPECIALITY CLINIC 230 MASONIC DRIVE INDEPENDENCE, LA 70443(985) 878-4174
PHY 9 2500
KENTWOOD ST. HELENA COMMUNITY HEALTH CENTER
721 AVE G KENTWOOD, LA 70444(985) 229-5501
FQHC 541 11500 AGES 6 MONTHS- 64 YEARS
PONCHATOULA
ALLENS FAMILY PRACTICE CLINIC 105 EAST OAK STREET PONCHATOULA, LA 70454(985) 386-6198
PHY CLINIC OR OTHER GROUP PRACTICE
294 5000 CURRENT PATIENTS AGES 0 - 64
WASHINGTON BOGALUSA CAILLOUET G 1616 S. COLUMBIA ST., SUITE C BOGALUSA, LA 70429(985) 735-7335
PHY GENERAL PRACTICE 8 10 CURRENT PATIENTS AGES 21 - 64
CASAMA ROGELIO 2807 S COLUMBIA STREET BOGALUSA, LA 70429(985) 735-8382
PHY INTERNAL MEDICINE 427 2500 AGES 21 - 64
FEINBERG JILL 1415 AVENUE F BOGALUSA, LA 70427(985) 735-1198
PHY FAMILY PRACTICE 455 2500 AGES 0 - 64
LSU WASHINGTON-ST TAMMAN 712 WILLIS AVE SUITE 4BOGALUSA, LA 70427(985) 730-2061
PHY 1213 5000 AGES 0 - 20
LSU WASHINGTON-ST TAMMAN 420 AVENUE F BOGALUSA, LA 70427(985) 732-0058
PHY 289 10000 AGES 0 - 64
LSU-WASHINGTON ST TAMMAN 400 MEMPHIS STREET BOGALUSA, LA 70427(985) 730-7193
PHY 370 8500 AGES 21 - 64
TABARI HOSSEIN 1616 S COLUMBIA ST,STE E BOGALUSA, LA 70427(985) 735-7810
PHY NEPHROLOGY 82 2500 CURRENT PATIENTS AGES 21 - 64
Page Number: 89CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
REGION 9
Parish City Provider Name Address Provider Type
Specialty Current CC Linkage
Potential Capacity
Restrictions
WASHINGTON BOGALUSA THE PEDIATRIC CLINIC 405 AVENUE F BOGALUSA, LA 70429(985) 732-1568
PHY CLINIC OR OTHER GROUP PRACTICE
2398 2500 AGES 0 - 64
THERIAULT VICTOR 712 WILLIS AVENUE BOGALUSA, LA 70427(985) 732-4853
PHY FAMILY PRACTICE 13 2500 CURRENT PATIENTS AGES 21 - 64
YERNENI PURNACHANDR 1011 AVENUE F BOGALUSA, LA 70427(985) 732-9940
PHY INTERNAL MEDICINE 411 2500 AGES 6 - 64
FRANKLINTON
ALVARADO LUIS 21012 HWY 16 FRANKLINTON, LA 70438(985) 795-0500
PHY INTERNAL MEDICINE 44 500 CURRENT PATIENTS AGES 21 - 64
CHILDREN'S IN TERNATIONAL 2208 WASHINGTON STREET FRANKLINTON, LA 70438(985) 795-2228
PHY 3 3500
FRANKLINTON RURAL HEALTH CLINIC 2004 J MARVIN MAGEE DRIVE FRANKLINTON, LA 70438(985) 839-3555
RHC RURAL HEALTH CLINIC
1064 2500 AGES 0 - 64
LSU WASHINGTON-ST TAMMAN 51704 HWY 438 FRANKLINTON, LA 70438(985) 848-9955
PHY 662 3000 AGES 0 - 64
Page Number: 90CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
LIVINGSTON OTHER 6
INTERNAL 1
FQHC 1
RHC 1
FAMILY PRACTICE 2
PEDIATRICS 2
TOTAL: 13 53,000 11,288
ST. HELENA OTHER 2
RHC 1
TOTAL: 3 12,500 2,552
ST. TAMMANY OTHER 14
INTERNAL 6
FAMILY PRACTICE 1
PEDIATRICS 5
FQHC 1
TOTAL: 27 127,050 30,958
TANGIPAHOA OTHER 9
FQHC 1
RHC 2
FAMILY PRACTICE 4
PEDIATRICS 2
INTERNAL 4
TOTAL: 22 110,500 27,390
WASHINGTON OTHER 7
CommunityCARE Provider Summary Count By ParishREGION 9
Page Number: 91CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Parish Specialty Number of CommunityCARE
Providers
Maximum Capacity
Current CC Linkages Total
WASHINGTON GENERAL PRACTICE
1
RHC 1
INTERNAL 3
FAMILY PRACTICE 2
TOTAL: 14 48,010 7,439
REGION TOTALS 79 351,060 79,627
Page Number: 92CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
CommunityCARE Provider and Physician Totals for the State of Louisiana
Provider Type Total CommunityCARE Providers
Total Maximum Capacity Current CC Linkages Total
State of Louisiana
FAMILY PRACTICE 115
FQHC 45
GENERAL PRACTICE 33
INTERNAL 76
OB/GYN 4
OTHER 384
PEDIATRICS 76
RHC 96
Total 829 3,274,775 765,381
Page Number: 93CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
KIDMED Providers by Parish
Region Parish City Name Provider Type Restriction Notes
REGION 1 EAST JEFFERSON HARVEY WEST JEFFERSON SBHC SBHC
METAIRIE JEFFERSON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
JEFFERSON JEFFERSON RIVERDALE HIGH SBHC SBHC
KENNER BONNABEL SBHC SBHC
MARRERO EHRET HIGH SBHC SBHC
JEFFERSON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
WESTWEGO BUTLER SBHC SBHC
ORLEANS NEW ORLEANS ALGIERS TECHNOLOGY ACADE KIDMED SCREENING CLINIC
ALICE M. HART E CHARTER SCHOOL KIDMED SCREENING CLINIC
DWIGHT D. EISENHOWER ACA KIDMED SCREENING CLINIC
EDNA KARR CHARTER HIGH SCHOOL KIDMED SCREENING CLINIC
ELEANOR MCMAIN SECONDARY SBHC SBHC
HARRIET ROSS TUBMAN CHARTER KIDMED SCREENING CLINIC
MARTIN BEHRMAN CHARTER A KIDMED SCREENING CLINIC
MCDONOUGH #32 LITERACY C KIDMED SCREENING CLINIC
MCLNO O PERRY WALKER SBH SBHC
NEW ORLEANS C HARTER SCIE SBHC
O. PERRY WALKER COLLEGE KIDMED SCREENING CLINIC
ORLEANS PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
RECOVERY SCHOOL DISTRICT KIDMED SCREENING CLINIC
TUHC DOWNTOWN PEDIATRIC PHY
WILLIAM J. FISHER ACCELE KIDMED SCREENING CLINIC
PLAQUEMINES BELLE CHASSE PLAQUEMINES PARISH SCH B KIDMED SCREENING CLINIC
ST. BERNARD CHALMETTE CHALMETTE HIGH SCHOOL SB SBHC
REGION 2 ASCENSION DONALDSONVILLE ASCENSION HEALTH UNIT-DO KIDMED SCREENING CLINIC
ASCENSION PARISH SCHOOL KIDMED SCREENING CLINIC
Page Number: 94CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 2 ASCENSION GONZALES ASCENSION PARISH GOVERNE KIDMED SCREENING CLINIC
EAST BATON ROUGE BATON ROUGE ADVANCED COMP . TEST-B.R. PHY
BROADMOOR HIGH SBHC SBHC
CENTRAL COMMUNITY SCHOOL DISTICT KIDMED SCREENING CLINIC
EAST BATON ROUGE HEALTH KIDMED SCREENING CLINIC
EAST BATON ROUGE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
GLASCOW MIDDLE SBHC SBHC
HCCS CAPITOL HIGH SBHC SBHC
HCCS GLEN OAKS HIGH SBHC SBHC
HCCS GLEN OAKS MIDDLE SB SBHC
HCCS ISTROUMA HIGH SBHC SBHC
HCCS PRESCOTT MIDDLE SBH SBHC
HCCS WESTDALE MIDDLE SBH SBHC
PRIDE HCCS NORTHEAST ELEM SBHC SBHC
HCCS NORTHEAST HIGH SBHC SBHC
ZACHARY MEDAMERICA -EISWORTH KIDMED SCREENING CLINIC
ZACHARY COMMUNITY SCHOOLS KIDMED SCREENING CLINIC
EAST FELICIANA CLINTON EAST FELICIAN A HEALTH UN KIDMED SCREENING CLINIC
IBERVILLE PLAQUEMINE IBERVILLE HEALTH UNIT-PL KIDMED SCREENING CLINIC
IBERVILLE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
ST GABRIEL EAST IBERVILL E ELEM/HIGH FQHC
POINTE COUPEE MORGANZA POINTE COUPEE CENTRAL HI FQHC AGES 4 - 20
NEW ROADS POINTE COUPEE HEALTH UNI KIDMED SCREENING CLINIC
POINTE COUPEE SCHOOL BOARD KIDMED SCREENING CLINIC
WEST BATON ROUGE PORT ALLEN W. BATON ROUGE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
WEST BATON ROUGE HEALTH KIDMED SCREENING CLINIC
WEST FELICIANA ST FRANCISVILLE FAMILY SERVICE CENTER SBHC
ST. FRANCISVILLE WEST FELICIAN A HEALTH UN KIDMED SCREENING CLINIC
Page Number: 95CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 2 WEST FELICIANA ST.FRANCISVILLE WEST FELICIANA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
REGION 3 ASSUMPTION NAPOLEONVILLE ASSUMPTION HEALTH UNIT KIDMED SCREENING CLINIC
ASSUMPTION PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
LAFOURCHE GALLIANO LAFOURCHE HEALTH UNIT-GA KIDMED SCREENING CLINIC
THIBODAUX LAFOURCHE HEALTH UNIT-TH KIDMED SCREENING CLINIC
LAFOURCHE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
ST. CHARLES LULING ST. CHARLES PARISH PUBLIC SCHOOL KIDMED SCREENING CLINIC
ST. JAMES GRAMERCY ST ELIZABETH PHYSICIANS PHY CURRENT PATIENTS AGES 0 - 14
LUTCHER ST. JAMES HEALTH UNIT KIDMED SCREENING CLINIC
ST. JOHN RESERVE ST. JOHN BPT PARISH SCHOOL KIDMED SCREENING CLINIC
ST. JOHN HEALTH UNIT-RES KIDMED SCREENING CLINIC
ST. MARY CENTERVILLE ST MARY PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
MORGAN CITY ST. MARY HEALTH UNIT- MO KIDMED SCREENING CLINIC
TERREBONNE HOUMA CLOUTIER ARNOLD L O. DISTRICT OPTOMETRIST AND OPTOMETRIST GROUP
TERREBONNE HEALTH UNIT KIDMED SCREENING CLINIC
TERREBONNE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
REGION 4 ACADIA CHURCH POINT ACADIA-ST. LANDRY HOSPIT KIDMED SCREENING CLINIC
CROWLEY ACADIA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
RAYNE ACADIA PAR POL JURY COMM KIDMED SCREENING CLINIC
EVANGELINE VILLE PLATTE EVANGELINE PARISH SCHOOL KIDMED SCREENING CLINIC
IBERIA NEW IBERIA IBERIA SCH BRD - ALL SITES KIDMED SCREENING CLINIC
LAFAYETTE LAFAYETTE CHILDREN HLTH CRE CL-ACA PHY
LAFAYETTE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
NORTHSIDE HIGH SBHC SBHC
UNIVERSITY MEDICAL CENTE KIDMED SCREENING CLINIC
ST. LANDRY OPELOUSAS CHILDREN'S KIDMED CLINIC KIDMED SCREENING CLINIC
ST LANDRY PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
Page Number: 96CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 4 ST. LANDRY SUNSET ST LANDRY PARISH POLICE KIDMED SCREENING CLINIC
ST LANDRY SB-SUNSET ELEM KIDMED SCREENING CLINIC
ST. MARTIN BREAUX BRIDGE BREAUX BRIDGE SBHC SBHC
ST MARTIN PARISH GOVERME KIDMED SCREENING CLINIC
ST MARTIN PARISH GOVERNM KIDMED SCREENING CLINIC
CECILIA CECILIA SBHC SBHC
ST MARTINVILLE ST MARTINVILLE SBHC SBHC
ST. MARTINVILLE ST. MARTIN PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
VERMILION ABBEVILLE VERMILION PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
REGION 5 ALLEN OAKDALE ALLEN HEALTH UNIT-OAKDAL KIDMED SCREENING CLINIC
OAKDALE SBHC SBHC
OBERLIN ALLEN PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
BEAUREGARD DERIDDER BEAUREGARD HEALTH UNIT KIDMED SCREENING CLINIC
BEAUREGARD PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
CALCASIEU LAKE CHARLES CALCASIEU HEALTH UNIT-LA KIDMED SCREENING CLINIC
CALCASIEU PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
CHRISTUS ST PATRICK HOSP PHY
CHRISTUS ST PATRICK HOSP PHY
CLIFTON ELEMENTARY SBHC SBHC
COMBRE FONDEL ELEM SBHC SBHC
M & M FAMILY CLINIC INC KIDMED SCREENING CLINIC
MOLO MIDDLE SBHC SBHC
WASHINGTON-MARION SBHC SBHC
SULPHUR CALCASIEU HEALTH UNIT-SU KIDMED SCREENING CLINIC
CAMERON CAMERON CAMERON HEALTH UNIT KIDMED SCREENING CLINIC
HACKBERRY CAMERON HEALTH UNIT-HACK KIDMED SCREENING CLINIC
LAKE CHARLES CAMERON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
JEFFERSON DAVIS JENNINGS JEFF DAVIS HEALTH UNIT KIDMED SCREENING CLINIC
Page Number: 97CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 5 JEFFERSON DAVIS JENNINGS JEFF DAVIS PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
REGION 6 AVOYELLES MANSURA AVOYELLES CHARTER SBHC SBHC
AVOYELLES SBHC SBHC
MARKSVILLE AVOYELLES PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
CATAHOULA JONESVILLE CATAHOULA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
CONCORDIA VIDALIA CONCORDIA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
GRANT COLFAX GRANT PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
DRY PRONG GRANT SBHC SBHC
POLLOCK POLLOCK SBHC SBHC
LA SALLE JENA JENA HIGH SBHC SBHC
JENA JR HIGH SBHC SBHC
LASALLE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
RAPIDES ALEXANDRIA HUEY P. LONG KIDMEDICAL KIDMED SCREENING CLINIC
RAPIDES PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
DEVILLE BUCKEYE SBHC SBHC
GLENMORA GLENMORA SBHC SBHC
LENA NORTHWOOD SBHC SBHC
PINEVILLE LESSIE MOORE SBHC SBHC
PINEVILLE JR HIGH SBHC SBHC
TIOGA HIGH SBHC SBHC
TIOGA JR HIGH SBHC SBHC
WINN WINNFIELD WINN PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
REGION 7 BIENVILLE ARCADIA BIENVILLE HEALTH UNIT-AR KIDMED SCREENING CLINIC
BIENVILLE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
BOSSIER BOSSIER CITY BOSSIER HEALTH UNIT - BO KIDMED SCREENING CLINIC
BOSSIER PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
CADDO SHREVEPORT ATKINS SBHC SBHC
CADDO HEALTH UNIT-S'PORT KIDMED SCREENING CLINIC
Page Number: 98CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 7 CADDO SHREVEPORT CADDO PAR SCHL BRD-ALL SITES KIDMED SCREENING CLINIC
LINWOOD SBHC SBHC
WOODLAWN SBHC SBHC
CLAIBORNE HOMER CLAIBORNE HEALTH UNIT KIDMED SCREENING CLINIC
DE SOTO MANSFIELD DESOTO SCHOOL BOARD-MANSFIELD KIDMED SCREENING CLINIC
NATCHITOCHES CAMPTI NATCHITOCHES S.B.-LAKEVI KIDMED SCREENING CLINIC
NATCHITOCHES SBHC SBHC
CLOUTIERVILLE CLOUTIERVILLE SBHC SBHC
NATCHITOCHES S.B.-CLOUTI KIDMED SCREENING CLINIC
COUSHATTA NATCHITOCHES S.B.-FAIRVI KIDMED SCREENING CLINIC
GOLDONNA NATCHITOCHES S.B.-GOLDON KIDMED SCREENING CLINIC
MARTHAVILLE MARTHAVILLE SBHC SBHC
NATCHITOCHES S.B.-MARTHA KIDMED SCREENING CLINIC
NATCHITOCHES NATCHITOCHES CENTRAL SBH SBHC
NATCHITOCHES HEALTH UNIT KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-E. NAT KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-LAKEVIEW HIGH KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-N. NAT KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-NAT. C KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-NAT. J KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-NAT. N KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-NSU EL KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-NSU MI KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-PARKS KIDMED SCREENING CLINIC
NATCHITOCHES S.B.-WEAVER KIDMED SCREENING CLINIC
PROVENCAL NATCHITOCHES S.B.-PROVEN KIDMED SCREENING CLINIC
RED RIVER COUSHATTA COUSHATTA KIDMED LLC KIDMED SCREENING CLINIC
RED RIVER HEALTH UNIT KIDMED SCREENING CLINIC
Page Number: 99CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 7 SABINE MANY DESOTO HEALTH UNIT KIDMED SCREENING CLINIC
SABINE HEALTH UNIT KIDMED SCREENING CLINIC
SABINE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
WEBSTER MINDEN WEBSTER HEALTH UNIT-MIND KIDMED SCREENING CLINIC
SPRINGHILL WEBSTER HEALTH UNIT-SPRI KIDMED SCREENING CLINIC
REGION 8 CALDWELL COLUMBIA CALDWELL HEALTH UNIT KIDMED SCREENING CLINIC
CALDWELL PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
COUGHRAN MEDI CAL CORPORA PHY
EAST CARROLL LAKE PROVIDENCE EAST CARROLL HEALTH UNIT KIDMED SCREENING CLINIC
EAST CARROLL PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
FRANKLIN WINNSBORO FRANKLIN HEALTH UNIT KIDMED SCREENING CLINIC
FRANKLIN PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
JACKSON JONESBORO JACKSON HEALTH UNIT KIDMED SCREENING CLINIC
JACKSON PARISH HOSPITAL SBHC
JACKSON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
LINCOLN RUSTON LINCOLN HEALTH UNIT KIDMED SCREENING CLINIC
LINCOLN PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
MADISON TALLULAH MADISON HEALTH UNIT KIDMED SCREENING CLINIC
MADISON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
MADISON SENIOR HIGH SBHC SBHC
MOREHOUSE BASTROP MOREHOUSE HEALTH UNIT KIDMED SCREENING CLINIC
MOREHOUSE JR HIGH SCHOOL FQHC
MOREHOUSE PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
OUACHITA MONROE MONROE CITY SCHOOL SYSTEM KIDMED SCREENING CLINIC
NORTHEAST RURAL HEALTH C PHY
OUACHITA HEALTH UNIT KIDMED SCREENING CLINIC
ST FRANCIS SBHC SBHC
WEST MONROE OUACHITA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
Page Number: 100CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report
Region Parish City Name Provider Type Restriction Notes
REGION 8 OUACHITA WEST MONROE RISER SBHC SBHC
WEST MONROE SBHC SBHC
RICHLAND DELHI RICHLAND PARISH HOSPITAL SBHC
RAYVILLE RICHARDSON MEDICAL CENTE SBHC
RICHLAND HEALTH UNIT KIDMED SCREENING CLINIC
RICHLAND PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
TENSAS ST. JOSEPH TENSAS HEALTH UNIT-ST. J KIDMED SCREENING CLINIC
ST.JOSEPH TENSAS PARISH SCHOOL SYSTEM KIDMED SCREENING CLINIC
UNION FARMERVILLE UNION HEALTH UNIT KIDMED SCREENING CLINIC
UNION PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
WEST CARROLL OAK GROVE WEST CARROLL HEALTH UNIT KIDMED SCREENING CLINIC
WEST CARROLL PARISH SCHOOLS KIDMED SCREENING CLINIC
REGION 9 LIVINGSTON LIVINGSTGON LIVINGSTON PARISH SCHOOL BRD KIDMED SCREENING CLINIC
LIVINGSTON LIVINGSTON HEALTH UNIT-L KIDMED SCREENING CLINIC
ST. HELENA GREENSBURG ST. HELENA COMMUNITY HLT FQHC AGES 9 - 15
ST. HELENA COMMUNITY HLT FQHC
ST. HELENA COMMUNITY HLT FQHC
ST. TAMMANY COVINGTON COMMUNITY WELLNESS CENTE KIDMED SCREENING CLINIC
TANGIPAHOA AMITE TANGIPAHOA HEALTH UNIT-A KIDMED SCREENING CLINIC
TANGIPAHOA PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
HAMMOND TANGIPAHOA HEALTH UNIT-H KIDMED SCREENING CLINIC
WASHINGTON BOGALUSA BOGALUSA CITY SCHOOL SYSTEM KIDMED SCREENING CLINIC
BOGALUSA HIGH SBHC SBHC
BOGALUSA JR HIGH SBHC SBHC
LSU WASHINGTON ST-TAMMAN PHY
LSU WASHINGTON-ST TAMMAN PHY
FRANKLINTON WASHINGTON PARISH SCHOOL BOARD KIDMED SCREENING CLINIC
Page Number: 101CCPCPLinkage_Public 4/4/2011 11:06:42 AM
Community Care PCP Linkage Report