Women's Clinic of Oakdale, LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

05120R Issued in LA

Legal business name

WOMEN'S CLINIC OF OAKDALE, LLC

Practice address

119 Hospital Dr
Oakdale, LA 71463-3034

Phone

(318) 335-0260

Fax

(318) 335-3356

NPI assigned

Feb 15, 2010

Last updated

Jan 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Medha M Kulkarni

Title

Administrator

Phone

(337) 468-2250

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023340254. Details of each certification follow.

• CCN 193898 Rural health clinic · Active · Name & address match · Details

Rural health clinic certification: CCN 193898

Legal name

WOMEN'S CLINIC OF OAKDALE LLC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jun 16, 2010

Last certification

Sep 6, 2023

Ownership / control type

1C

Facility address

119 N Hospital Drive
Oakdale, LA 71463

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Kaitlyn Maricle

  • Family Nurse Practitioner
  • Oakdale, LA
  • NPI 1023804127
  NPD (past)

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

{
    "created_epoch": "1266192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1023340254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 CHERRY ST",
            "address_2": "SUITE A",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "705542223",
            "telephone_number": "337-468-2250",
            "fax_number": "337-468-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 HOSPITAL DR",
            "city": "OAKDALE",
            "state": "LA",
            "postal_code": "714633034",
            "telephone_number": "318-335-0260",
            "fax_number": "318-335-3356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMEN'S CLINIC OF OAKDALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-15",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "KULKARNI",
        "authorized_official_first_name": "MEDHA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "337-468-2250"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "LA",
            "license": "05120R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP CCN",
            "identifier": "2121014",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEMBER PTAN",
            "identifier": "53433DM43",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAE PART A",
            "identifier": "19-3898",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE CCN",
            "identifier": "2121014",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2121014",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5DM43",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY HEALTH SOLUTIONS CCN",
            "identifier": "2121014",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Oakdale, LA
• Providers in Oakdale, LA by specialty
• Obstetrics & Gynecology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.