Cardiovascular Institute of the South ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC, LLC

Practice address

191 Innovation Court
Gray, LA 70359

Phone

(985) 876-0300

NPI assigned

Jun 9, 2020

Last updated

Jun 9, 2020By 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

Mr. David C Konur

Title

Chief Executive Officer

Phone

(985) 876-0300

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Listed as

Cardiovascular Institute of the South ASC LLCCCN 19C0001142

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

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

• Cardiovascular Institute of the South, Apmc

  dba Family Doctors Clinic of Mathews

  • Prosthetic/Orthotic Supplier
  • Raceland, LA
  • NPI 1477734424

  Member Of

  NPD member

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.

• Craig Michael Walker, MD

  • Interventional Cardiology Physician
  • Houma, LA
  • NPI 1548267529
  NPD (past)

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

{
    "created_epoch": "1591660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1033734785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4176",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703614176",
            "telephone_number": "985-876-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 INNOVATION COURT",
            "city": "GRAY",
            "state": "LA",
            "postal_code": "70359",
            "telephone_number": "985-876-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARDIOVASCULAR INSTITUTE OF THE SOUTH ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-09",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "KONUR",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "985-876-0300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna Kay Blanchard, MD
• Anita Bonvillain, LPC
• Tiffany Lashone Borne
• Katie Elizabeth Boudreaux, SLP
• Darin R Branson, APRN FNP-C
• Amanda Charpentier, NP
• Teri Lynn Chatagnier, LPC
• Chosen Lab Services LLC
• Brandi Clark, MS, ATC, LAT
• Susan Folse Crochet, RN

• Ambulatory Surgical Clinic/Center in Gray, LA
• Providers in Gray, LA by specialty
• Ambulatory Surgical Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.