NPIMap

Organization Active NPI

East Jefferson Physicians Group Urgent Care

  • Urgent Care Clinic/Center
  • Kenner, LA
National Provider Identifier
1053859082
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
EAST JEFFERSON PHYSICIANS GROUP URGENT CARE
Practice address
708 W Esplanade Ave
Kenner, LA 70065-2736
Phone
(504) 503-5100
NPI assigned
Feb 9, 2017
Last updated
Feb 9, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST JEFFERSON PHYSICIAN GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Robert Riley
Title
Interim Chief Financial Officer
Phone
(504) 503-6409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

708 W Esplanade Ave
Kenner, LA 70065-2736

Mailing address

4300 Houma Blvd
Suite 202
Metairie, LA 70006-2932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090127000299 LA Part B Supplier - Clinic/Group Practice 4587660402 Receives reassigned benefits from 328 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Metairie, LA; Baton Rouge, LA; River Ridge, LA; Slidell, LA; Thibodaux, LA; Bogalusa, LA; Covington, LA; Greensburg, LA…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
East Jefferson Phys GRP LLC

Locations

4228 Houma Blvd
Fl 3
Metairie, LA 70006
Phone (504) 454-2222

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 47

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.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1053859082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 HOUMA BLVD",
            "address_2": "SUITE 202",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700062932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 W ESPLANADE AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700652736",
            "telephone_number": "504-503-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST JEFFERSON PHYSICIANS GROUP URGENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EAST JEFFERSON PHYSICIAN GROUP LLC",
        "enumeration_date": "2017-02-09",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "INTERIM CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "504-503-6409"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kenner, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.

Verify at the official NPI Registry.