NPIMap

Organization Active NPI

West Jefferson CT Scan LLC

  • Physiological Laboratory
  • Marrero, LA
National Provider Identifier
1013918077
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
WEST JEFFERSON CT SCAN LLC
Practice address
4525 Westbank Expy
Suite a
Marrero, LA 70072-3120
Phone
(504) 349-6570
Fax
(504) 349-6575
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Edwin B. Ross Jr., MD
Title
President
Phone
(504) 391-7650

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X Primary

Addresses

Primary practice location

4525 Westbank Expy
Suite a
Marrero, LA 70072-3120

Mailing address

4525 Westbank Expy
Suite a
Marrero, LA 70072-3120
Phone (504) 349-6570

Other identifiers 1

IdentifierTypeStateIssuer
1447285MedicaidLA

Other names 1

  • Louisiana Imaging Center of West Jefferson Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4525 Westbank Expy
Ste A
Marrero, LA 70072
Phone (504) 349-6570

Practitioners & affiliated clinicians

Practitioners 3

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": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1013918077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 WESTBANK EXPY",
            "address_2": "SUITE A",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723120",
            "telephone_number": "504-349-6570",
            "fax_number": "504-349-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4525 WESTBANK EXPY",
            "address_2": "SUITE A",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723120",
            "telephone_number": "504-349-6570",
            "fax_number": "504-349-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST JEFFERSON CT SCAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-391-7650",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447285",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Louisiana Imaging Center of West Jefferson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.