Northlake Primary Care

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD11789R Issued in LA

Legal business name

NORTHLAKE PRIMARY CARE

Practice address

951 Gause Blvd Ste 2
Slidell, LA 70458-2937

Phone

(985) 641-6454

Fax

(985) 641-6458

NPI assigned

Apr 18, 2007

Last updated

Aug 22, 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

Dr. Jose Antonio Lefran, MDNPI 1750437216

Title

Doctor

Phone

(985) 641-6454

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Jose Antonio Lefran, M.D

  • Hematology & Oncology Physician
  • Slidell, LA
  • NPI 1750437216

  Internal Medicine

  NPD (past) Authorized official
• Sally S. Ball, MD

  • Internal Medicine Physician
  • Shreveport, LA
  • NPI 1568441251
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063638831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 GAUSE BLVD STE 2",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582937",
            "telephone_number": "985-641-6454",
            "fax_number": "985-641-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 GAUSE BLVD STE 2",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582937",
            "telephone_number": "985-641-6454",
            "fax_number": "985-641-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAKE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEFRAN",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "985-641-6454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD11789R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14557",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northlake Cardiology Diagnostics LLC
• Northlake Eye Center, Apmc
• Northlake Hematology/Oncology Associates
• Northlake Interventional Pain Management, LLC
• Northlake Oral and Facial Surgery LLC
• Northlake Radiology Consultants, Apmc
• Northland Hearing Centers Inc (Sears Hearing Aid Centers)
• Northland Hearing Centers, Inc. (Audibel Hearing Healthcare)
• Northshore Audiology, LLC
• Northshore Cardiovascular Associates LLC

• Internal Medicine Physician in Slidell, LA
• Providers in Slidell, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.