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Southern Pediatric Clinic

Health Service Clinic/Center in Oakdale, LA · enumerated 2015 · authorized official Stella Immanuel, Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104296417

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Registry record

Entity type Organization (Type 2)
Legal business name Southern Pediatric Clinic
Practice address 905 E 7th Ave, Suite 9, Oakdale, LA, 71463
Phone (318) 215-8150
Fax (318) 215-8151
Enumeration date Sep 29, 2015
Last updated in NPPES Nov 3, 2015

Taxonomy & classification

261QH0100X Health Service Clinic/Center Ambulatory Health Care Facilities · License MD12866R (LA) Primary

Authorized official

Name Stella Immanuel
Title Owner
Phone (318) 215-8150

Other identifiers

Identifier Type State Issuer
1449237 Medicaid LA -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Southern Pediatric Clinic?
NPPES lists Stella Immanuel (Owner) as the authorized official for this organization.
What is the NPI number for Southern Pediatric Clinic?
The NPI for Southern Pediatric Clinic is 1104296417, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2015-11-03.