Organization Active NPI

Lafayette Heart Clinic, LLC

  • Cardiovascular Disease Physician
  • Lafayette, LA
National Provider Identifier
1023225356
Registry record updated Sep 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LAFAYETTE HEART CLINIC, LLC
Practice address
5000 Ambassador Caffery Pkwy
Province Building 1
Lafayette, LA 70508
Phone
(337) 261-0928
Fax
(337) 233-7773
NPI assigned
May 17, 2007
Last updated
Sep 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2013

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

Authorized official

Name
Christopher T Mallavarapa, MD
Title
MD/Owner
Phone
(337) 261-0928

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Nuclear Cardiology Physician 207UN0901X NU

Addresses

Primary practice location

5000 Ambassador Caffery Pkwy
Province Building 1
Lafayette, LA 70508

Mailing address

5000 Ambassador Caffery Pkwy
Province, Building 1
Lafayette, LA 70508
Phone (337) 261-0928

Other identifiers 1

IdentifierTypeStateIssuer
1448460MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378944000000",
    "number": "1023225356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY",
            "address_2": "PROVINCE, BUILDING 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-261-0928",
            "fax_number": "337-233-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 AMBASSADOR CAFFERY PKWY",
            "address_2": "PROVINCE BUILDING 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-261-0928",
            "fax_number": "337-233-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE HEART CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2013-09-12",
        "status": "A",
        "authorized_official_last_name": "MALLAVARAPA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "337-261-0928",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1448460",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2013; 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.