Active NPI
Raceland Emergency Group, LLC
- Emergency Medicine Physician
- Raceland, LA
National Provider Identifier
1023604352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- RACELAND EMERGENCY GROUP, LLC
- Practice address
- 4608 Highway 1
Raceland, LA 70394-2623 - Phone
- (985) 537-6841
- NPI assigned
- Dec 21, 2020
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Lisha C. Falk
- Title
- VP of Contracting
- Phone
- (337) 609-1221
Practitioners 34
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210129000530 | LA | Part B Supplier - Clinic/Group Practice | 4082028261 |
Receives reassigned benefits from 34 practitioners Practice locations: Raceland, LA |
National Provider Directory
National Provider DirectorySpecialties & licenses 3
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Physician Assistant | 363A00000X | |||
| Nurse Practitioner | 363L00000X |
Addresses
NPPES NPI RegistryPrimary practice location
4608 Highway 1
Raceland, LA 70394-2623
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 7, 2021.
{
"created_epoch": "1608508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1638835200000",
"number": "1023604352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CORPORATE BLVD",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705083870",
"telephone_number": "800-893-9698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4608 HIGHWAY 1",
"city": "RACELAND",
"state": "LA",
"postal_code": "703942623",
"telephone_number": "985-537-6841"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RACELAND EMERGENCY GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-12-21",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A",
"authorized_official_last_name": "FALK",
"authorized_official_first_name": "LISHA",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "VP OF CONTRACTING",
"authorized_official_telephone_number": "337-609-1221"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raceland, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.