NPIMap

Organization Active NPI

Medical Professional Clinical Services

  • Family Nurse Practitioner
  • Plaquemine, LA
National Provider Identifier
1013420264
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MEDICAL PROFESSIONAL CLINICAL SERVICES
Practice address
59215 River West Dr
Plaquemine, LA 70764-6552
Phone
(225) 954-5596
NPI assigned
Nov 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joseph Wade Delaughter Jr., NPNPI 1578703674
Title
Owner
Phone
(225) 954-5596

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

59215 River West Dr
Plaquemine, LA 70764-6552

Mailing address

8733 Siegen LN # 104
Baton Rouge, LA 70810-1945
Phone (225) 954-5596

Other practice location 1

403 N 15th St
Port Allen, LA 70767-2264
Phone (225) 954-5596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191028001850 LA Part B Supplier - Clinic/Group Practice 2466784228 Receives reassigned benefits from 8 practitioners
Practice locations: Franklin, LA; Morgan City, LA; Plaquemine, LA; Port Allen, LA; Tallulah, LA; Winnsboro, LA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570147200000",
    "number": "1013420264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8733 SIEGEN LN # 104",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101945",
            "telephone_number": "225-954-5596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59215 RIVER WEST DR",
            "city": "PLAQUEMINE",
            "state": "LA",
            "postal_code": "707646552",
            "telephone_number": "225-954-5596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 N 15th St",
            "address_purpose": "LOCATION",
            "city": "Port Allen",
            "state": "LA",
            "postal_code": "707672264",
            "country_code": "US",
            "telephone_number": "225-954-5596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL PROFESSIONAL CLINICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2019-10-04",
        "status": "A",
        "authorized_official_last_name": "DELAUGHTER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-954-5596",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plaquemine, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.