Organization Active NPI

Alexandria Rheumatology, LLC

  • Clinic/Center
  • Alexandria, LA
National Provider Identifier
1073774030
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
11711R Issued in LA
Legal business name
ALEXANDRIA RHEUMATOLOGY, LLC
Practice address
3311 Prescott Rd Ste 211
Alexandria, LA 71301-3983
Phone
(318) 767-8393
Fax
(318) 767-8399
NPI assigned
Jun 23, 2008
Last updated
Nov 19, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Authorized official

Name
Dr. Mohammad Izzat Shbeeb, M.D.NPI 1255361069
Title
Physician
Phone
(318) 767-8393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 11711R LA Primary

Addresses

Primary practice location

3311 Prescott Rd Ste 211
Alexandria, LA 71301-3983

Mailing address

3311 Prescott Rd Ste 211
Alexandria, LA 71301-3983
Phone (318) 767-8393

Other identifiers 1

IdentifierTypeStateIssuer
1690317MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000187 LA Part B Supplier - Clinic/Group Practice 5698816650 Receives reassigned benefits from 1 practitioner
Practice locations: Alexandria, LA

National Provider Directory

National Provider Directory

Locations

3311 Prescott Rd
Ste 211
Alexandria, LA 71301
Phone (318) 445-3636

3349 Masonic Dr
Alexandria, LA 71301
Phone (318) 767-8393

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542585600000",
    "number": "1073774030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD STE 211",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013983",
            "telephone_number": "318-767-8393",
            "fax_number": "318-767-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 PRESCOTT RD STE 211",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013983",
            "telephone_number": "318-767-8393",
            "fax_number": "318-767-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEXANDRIA RHEUMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2018-11-19",
        "status": "A",
        "authorized_official_last_name": "SHBEEB",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "IZZAT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "318-767-8393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "LA",
            "license": "11711R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1690317",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2018; 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.