Pediatric Medical Clinic Inc

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

015291 Issued in LA

Legal business name

PEDIATRIC MEDICAL CLINIC INC

Practice address

501 Rue de Sante
Suite 9
La Place, LA 70068-5400

Phone

(985) 651-7444

Fax

(985) 651-7449

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Oliver Roy Lambert, MD

Title

Physician

Phone

(985) 651-7444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184544000000",
    "number": "1043376007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 RUE DE SANTE",
            "address_2": "SUITE 9",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685400",
            "telephone_number": "985-651-7444",
            "fax_number": "985-651-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 RUE DE SANTE",
            "address_2": "SUITE 9",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685400",
            "telephone_number": "985-651-7444",
            "fax_number": "985-651-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-16",
        "status": "A",
        "authorized_official_last_name": "LAMBERT",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "ROY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "985-651-7444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "LA",
            "license": "015291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449369",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; 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.