Individual provider Active NPI

CHI Phuong Dola, M.D.

  • Maternal & Fetal Medicine Physician
  • Harvey, LA
National Provider Identifier
1063511590
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
021413 Issued in LA
Practice address
3909 Lapalco Blvd
Suite 200
Harvey, LA 70058-2302
Phone
(504) 349-6216
Fax
(985) 626-6995
NPI assigned
Sep 21, 2006
Last updated
Jan 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine Physician 207VM0101X 021413 LA Primary

Addresses

Primary practice location

3909 Lapalco Blvd
Suite 200
Harvey, LA 70058-2302

Mailing address

3909 Lapalco Blvd
Suite 200
Harvey, LA 70058-2302
Phone (504) 349-6216

Other identifiers 1

IdentifierTypeStateIssuer
1699071MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000433 LA Practitioner - Obstetrics/Gynecology 7810902343 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Tulane University School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4720 S I 10 Service Rd W
Metairie, LA 70001-7404
Phone (504) 988-8070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
021413LAMDMaternal & Fetal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 1997 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Aug 1, 1997 Accepting new patients
The Woman's Clinic of Marrero Inc CurrentSince Dec 1, 2005 Accepting new patients
The Retina Institute, L.L.C. Past Accepting new patients
The Administrators of the Tulane Educational Fund Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients
University Healthcare System, L.C. Past Accepting new patients
Optima Eye Care, LLC PastSince Dec 1, 2005 Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

3909 Lapalco Blvd
Ste 200
Harvey, LA 70058
Phone (504) 349-6216

4945 Lapalco Blvd
Ste 100
Marrero, LA 70072
Phone (504) 349-6216

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

4720 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-4583

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1450 Poydras St
New Orleans, LA 70112
Phone (504) 903-2373

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1063511590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 LAPALCO BLVD",
            "address_2": "SUITE 200",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582302",
            "telephone_number": "504-349-6216",
            "fax_number": "985-626-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 LAPALCO BLVD",
            "address_2": "SUITE 200",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582302",
            "telephone_number": "504-349-6216",
            "fax_number": "985-626-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLA",
        "first_name": "CHI",
        "middle_name": "PHUONG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "LA",
            "license": "021413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699071",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, LA

Sources for this page

Verify at the official NPI Registry.