NPIMap

Organization Active NPI

Mobile Diagnostics of Lafayette LLC

  • Clinical Medical Laboratory
  • Lafayette, LA
National Provider Identifier
1053450668
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MOBILE DIAGNOSTICS OF LAFAYETTE LLC
Practice address
155 Hospital Dr
Suite 201
Lafayette, LA 70503-2852
Phone
(337) 235-0888
Fax
(337) 237-3700
NPI assigned
Feb 6, 2007
Last updated
Apr 25, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Dr. James C Ingram Jr., M.D.
Title
Vice President
Phone
(337) 235-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

155 Hospital Dr
Suite 201
Lafayette, LA 70503-2852

Mailing address

PO Box 52970
Lafayette, LA 70505-2970
Phone (337) 235-0888

Other identifiers 1

IdentifierTypeStateIssuer
F9591OtherLABLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1053450668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52970",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052970",
            "telephone_number": "337-235-0888",
            "fax_number": "337-237-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 HOSPITAL DR",
            "address_2": "SUITE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032852",
            "telephone_number": "337-235-0888",
            "fax_number": "337-237-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DIAGNOSTICS OF LAFAYETTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "INGRAM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "337-235-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "F9591",
            "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 Apr 25, 2012; 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.